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University of Tennessee, KnoxvilleTrace: Tennessee Research and CreativeExchange
Doctoral Dissertations Graduate School
8-2016
Effects of Television Viewing On Psycho-Physiological And Behavioral OutcomesBrittany Star OverstreetUniversity of Tennessee, Knoxville, [email protected]
This Dissertation is brought to you for free and open access by the Graduate School at Trace: Tennessee Research and Creative Exchange. It has beenaccepted for inclusion in Doctoral Dissertations by an authorized administrator of Trace: Tennessee Research and Creative Exchange. For moreinformation, please contact [email protected].
Recommended CitationOverstreet, Brittany Star, "Effects of Television Viewing On Psycho-Physiological And Behavioral Outcomes. " PhD diss., University ofTennessee, 2016.https://trace.tennessee.edu/utk_graddiss/3952
To the Graduate Council:
I am submitting herewith a dissertation written by Brittany Star Overstreet entitled "Effects of TelevisionViewing On Psycho-Physiological And Behavioral Outcomes." I have examined the final electronic copyof this dissertation for form and content and recommend that it be accepted in partial fulfillment of therequirements for the degree of Doctor of Philosophy, with a major in Kinesiology and Sport Studies.
David R. Bassett, Major Professor
We have read this dissertation and recommend its acceptance:
Kelley Strohacker, Scott Crouter, Debora Baldwin
Accepted for the Council:Dixie L. Thompson
Vice Provost and Dean of the Graduate School
(Original signatures are on file with official student records.)
i
Effects of Television Viewing On Psycho-Physiological And Behavioral Outcomes
A Dissertation Presented for the
Doctor of Philosophy Degree
The University of Tennessee, Knoxville
Brittany Star Overstreet
August 2016
ii
DEDICATION
This dissertation is dedicated to my family who has been by my side throughout this
journey. In particular, to my husband Matt whose unwavering faith and support kept me pushing
forward. Also, to my mom, dad, brothers and new extended family, this wouldn’t have been
possible without your continuous love. Thank you all for being understanding and encouraging
of my dreams.
iii
ACKNOWLEDGEMENT
Throughout my academic career I have been fortunate enough to be surrounded by some
of the most intelligent professionals in the field of exercise physiology. I would like to thank all
of my lab mates and friends for the motivation to pursue this degree. I also wish to thank my
committee members Drs. David Bassett, Jr., Kelley Strohacker, Scott Crouter and Debora
Baldwin for your dedication to this project and my professional development. Thank you for
sharing your knowledge, your skills, and your time, and for always challenging me to be my
best.
iv
ABSTRACT
Purpose: To determine the effects of television viewing during exercise on 1) preference for
exercise and 2) treadmill walking time. Methods: Twenty-five insufficiently active adults
(mean±standard deviation; age: 46±12 years; Body mass index: 31±5 kilogram/squared meter
(kg/m2) were recruited for this study. In part 1, participants performed three randomized 1/3-mile
walking bouts at an intensity equivalent to 70% of their oxygen consumption at ventilatory
threshold (VO2-at-VT). During these exercise bouts, individuals viewed 1) their favorite
television program (FavTV), 2) a standardized nature program (NatTV) or 3) no-TV program
(NoTV). A behavioral choice paradigm was used to assess preference for exercising with each
television condition. In part two, participants completed two randomized 60-minute visits in
which they were asked to walk at 70% of VO2-at-VT for 10-minutes under FavTV or NoTV
conditions. After 10 minutes, participants could choose to continue exercising under the current
TV condition or stop exercising and watch television while seated. Participants were allowed to
switch between exercise and rest as they desired during the remaining 50 minutes. Results:
Preference for exercise was greater during FavTV and NatTV versus NoTV (p<0.05), with no
differences between FavTV and NatTV (p=0.132). Despite difference in preferences for exercise,
no significant difference in treadmill walking time was observed for FavTV vs NoTV (50.0
versus 44.7 minutes, respectively; p=0.102). Conclusions: This study provides empirical
evidence that inactive individuals prefer walking with television viewing over walking with no
television. Further research is needed to determine if active television viewing can translate to
observable changes in exercise behaviors.
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TABLE OF CONTENTS
CHAPTER I INTRODUCTION ................................................................................................. 1 PHYSICAL ACTIVITY PARTICIPATION ............................................................................................. 2 TELEVISION VIEWING AND HEALTH RISKS .................................................................................... 3 CONSTRUCTS ASSOCIATED WITH BEHAVIOR .................................................................................. 5 PREFERENCES FOR ACTIVITIES ...................................................................................................... 6 TELEVISION VIEWING AND THE EXERCISE EXPERIENCE ................................................................. 8 STATEMENT OF PROBLEM ............................................................................................................ 10 STATEMENT OF PURPOSE ............................................................................................................. 10 SIGNIFICANCE OF THE STUDY ..................................................................................................... 11
CHAPTER II LITERATURE OF THE REVIEW ................................................................. 12
THEORETICAL FRAMEWORK ........................................................................................................ 13 AFFECTIVE RESPONSES ................................................................................................................ 14 ENJOYMENT OF EXERCISE ........................................................................................................... 19 PREFERENCE, AFFECTIVE RESPONSES, ENJOYMENT OF EXERCISE ................................................ 20 SUMMARY .................................................................................................................................. 27
CHAPTER III MANUSCRIPT .................................................................................................. 29
ABSTRACT .................................................................................................................................. 30 INTRODUCTION ........................................................................................................................... 31 METHODS ................................................................................................................................... 35
PARTICIPANTS ................................................................................................................................................ 35 EXPERIMENTAL OVERVIEW ......................................................................................................................... 36 PROCEDURES .................................................................................................................................................. 37 INITIAL ASSESSMENT (VISIT 1) .............................................................................................................. 37 ANTRHOPOMETRIC AND PSYCHOMETRIC ASSESSMENTS ................................................................ 37 GRADED EXERCISE TEST ......................................................................................................................... 37 BEHAVIORAL CHOICE PARADIGM (VISIT 2) ............................................................................................. 38 OBSERVABLE BEHAVIOR (VISITS 3 AND 4) ................................................................................................. 40 INSTRUMENTS ................................................................................................................................................. 41 THE PREFERENCE AND TOLERANCE FOR INTENSITY OF EXERCISE QUESTIONNAIRE .............. 41 THE BEHAVIORAL REGULATION IN EXERCISE QUESTIONNAIRE .................................................... 41 THE PHYSICAL ACTIVITY ENJOYMENT SCALE ..................................................................................... 41 THE RATING OF PERCIEVED EXERTION SCALE .................................................................................. 41 THE FEELING SCALE ................................................................................................................................. 41
STATISTICAL ANALYSIS .............................................................................................................. 42 PART A ............................................................................................................................................................. 42 PART B .............................................................................................................................................................. 42
RESULTS ..................................................................................................................................... 43 PART A ............................................................................................................................................................. 43 PART B .............................................................................................................................................................. 44
DISCUSSION ................................................................................................................................ 45 CONCLUSION ............................................................................................................................... 50
LIST OF REFERENCES ............................................................................................................ 51 APPENDICES .............................................................................................................................. 61
APPENDIX A. TABLES AND FIGURES ........................................................................................... 62
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APPENDIX B. INFORMED CONSENT ............................................................................................. 69 APPENDIX C. RECRUITMENT FLYER ........................................................................................... 73 APPENDIX D. PARTICIPANT RECRUITMENT EMAIL ....................................................................... 75 APPENDIX E. PARTICIPANT RESULTS SHEET ................................................................................ 77 APPENDIX F. BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY ............................................. 79 APPENDIX G. HEALTH HISTORY QUESTIONNAIRE ........................................................................ 82 APPENDIX H. PREFERENCE AND TOLERANCE FOR INTENSITY OF EXERCISE QUESTIONNAIRE ...... 84 APPENDIX I. BEHAVIORAL REGULATION IN EXERCISE QUESTIONNAIRE ....................................... 86 APPENDIX J. RATING OF PERCIEVED EXERTION ........................................................................... 89 APPENDIX K. FEELING SCALE ..................................................................................................... 91 APPENDIX L. PHYSICAL ACTIVITY ENJOYMENT SCALE ................................................................ 93
APPENDIX M. BEHAVIORAL CHOICE PARADIGM APPROACH PRACTICE QUESTIONNAIRE .............. 96 APPENDIX N. BEHAVIORAL CHOICE PARADIGM APPROACH QUESTIONNAIRES ............................. 98
APPENDIX O. PARTICIPANT DEBRIEF SCRIPT ............................................................................. 102
VITA ........................................................................................................................................... 104
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LIST OF TABLES
TABLE 1. PARTICIPANT CHARACTERISTICS ...................................................................... 66 TABLE 2. RELATIVE PREFERENCE FOR EXERCISE SCORES UNDER THREE TELEVISION-VIEWING CONDITIONS ................................................................................... 67 TABLE 3. FEELING SCALE, HEART RATE AND RATING OF PERCIEVED EXERTION RESPONSES TO EXERCISE UNDER VARIOUS TELEVISION CONDITIONS .................. 68 TABLE 4. RESULTS FROM REGRESSION ANALYSIS ......................................................... 69
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LIST OF FIGURES
FIGURE 1. VISIT 2 EXPERIMENTAL DESIGN FLOWCHART ............................................. 70 FIGURE 2. AVERAGE WALKING DURATION DURING FAVORITE TELEVISION PROGRAM AND NO TELEVISION PROGRAM CONDITIONS ............................................ 71
1
CHAPTER I
Introduction
2
Physical Activity Participation
Participation in physical activity (PA) is associated with health benefits such as
reductions in all-cause mortality and morbidity1, 2, cardiovascular disease3-6, metabolic diseases
(e.g. diabetes, obesity, hypertension)7-9 and some cancers10, 11. In fact, over 40% of premature
deaths can be attributed to modifiable behaviors such as improper diet and being inactive12. In
order to obtain health benefits, the Center for Disease Control and Prevention, along with the
American College of Sports Medicine (ACSM), recommend that individuals obtain at least 150
minutes of moderate-intensity aerobic PA, 75 minutes of vigorous-intensity aerobic PA or an
equivalent combination of the two each week13. Additionally, these guidelines recommend that
adults perform muscle-strengthening activities for all major muscle groups on two or more days
each week. Despite these well-known health benefits, only one in five U.S. adults self-reports
meeting the national aerobic PA recommendations14. Additionally, of those who start an exercise
regimen, approximately 50% drop out within the first six months15.
Many barriers to exercise exist that may contribute to these low PA participation rates.
Variables including age16, 17, gender18, and socioeconomic statuses (SES)17, 19 have been shown
to contribute to individual differences in perceived barriers. For example, independent
components of SES including an individual’s income, education, occupation, and residential area
are suggested to have a direct impact on one’s choice to participate in PA. Specifically, low-
income individuals may be deterred from purchasing gym membership or home exercise
equipment due to the associated costs. Additionally, free forms of PA such as walking around
one’s neighborhood may be challenging for low SES individuals if their residential areas do not
have accessible sidewalks, lighted walkways, or are located in less safe areas compared to higher
SES neighborhoods.
3
In addition to the above-mentioned barriers to exercise, self-motivation is also associated
with participation in PA20. Motivation towards a behavior can be classified on a continuum that
ranges from extrinsic, which is the least autonomous form, to intrinsic, the most autonomous
form. Motivation, specifically intrinsic motivation, is closely related to the reinforcing value of a
behavior21, 22. In regards to PA, extrinsic motivators such as verbal praise and financial
incentives are beneficial for initiating exercise programs23-25. While evidence suggests that
extrinsic motivators may be beneficial for promoting initial engagement, these motivators
typically do not result in long-term adherence to exercise programs23, 26, 27. Thus, it is necessary
to find ways to promote intrinsic motivation through increased feelings of pleasure and
enjoyment, given that greater intrinsic motivation towards exercise is associated with greater
adherence to programs28.
Although individuals differ in their perceived barriers and motivation levels, lack of time
is the most commonly cited barrier to exercise. Despite this perceived lack of time to exercise
amongst the general public, the average U.S. adult self-reports approximately five hours each
day designated towards leisure-time activities (i.e.- those outside of work and sleep). On average,
approximately 53% of leisure time (2.77 hours) is designated to television viewing (most of
which is sedentary), while only 0.30 hours is spent in sport, exercise, or recreational activities29.
These statistics raise concern among health professionals, as increasing evidence demonstrates
that prolonged time in sedentary behaviors poses additional health risks, independent of
participation in PA30, 31, and thus, potentially increasing the risk for cardiovascular, metabolic, or
other diseases.
4
Television Viewing and Health Risks
Television viewing has been show to be independently associated with increased health
risks such as obesity32-34, type II diabetes32, cardiovascular disease risk factors34-38, and all-cause
mortality37, 38. A survey of 3,392 Australian adults demonstrated a dose-depended relationship
between hours of seated television viewing and the risk for obesity. Individuals who watched 1-
2.5 hours, 2.5-4 hours, or greater than 4 hours of television each day were 93%, 183% and 300%
more likely to be overweight (body mass index (BMI) >25 kg/m2), respectively, compared to
individuals who watched less than 1 hour per day. Additionally, individuals who watched greater
than 4 hours each day were twice as likely to be overweight, even after controlling for PA
levels31. Moreover, a recent meta-analysis examining health risks associated with television
viewing concluded that for every two hours of television watched per day, the relative risk for
type II diabetes increased 20%, while relative risk for cardiovascular disease increased 15% and
the relative risk for all-cause mortality increased 13%39.
In addition to the negative health consequences related to sedentary television viewing,
physical inactivity negatively impacts the economy. Approximately 11.1% of all U.S. health care
expenditures are directly related to individuals being insufficiently active40. This is equivalent to
$117 billion dollars per year in direct health care expenditures and does not include costs
associated with disability, illness, or premature death related to inactivity40. Given the significant
health risks and financial costs of physical inactivity, the U.S. Department of Health and Human
Services has added “understanding the knowledge, attitudes, and behavioral/social skills
associated with adopting and maintaining a regular exercise program” to its list of primary
research objectives41, 42. Thus, there is a need for health care professionals to find effective ways
to enhance the exercise experience, in order to help individuals meet national PA guidelines.
5
Constructs Associated with Behavior
The Hedonic Theory of Motivation (HTM)43 purportedly explains why individuals make
specific PA related behavioral choices. The HTM states that individuals participate in activities
that make them feel good and avoid those that make them feel bad. While historically, exercise
was purported to make individuals feel good44-46, methodological errors of early exercise
psychology research (pre/post exercise measurements only) resulted in overgeneralized
conclusions that overlooked important patterns of feelings individuals experience during
exercise. Recent evidence suggests that, for the general population, exercise (particularly when
the exercise intensity exceeds ventilatory threshold (VT) elicits negative, unpleasureable
feelings. Even moderate-intensity exercise may elicit negative feelings for some individuals47 as
demonstrated by a high degree of inter-individual variability in affective responses at or slightly
below one’s VT. This inter-individual variability has caused problems for statistical analyses in
such studies, as group level analysis may mask individual responses48. Given that moderate-
intensity is commonly prescribed in exercise programs, emphasis is now being placed on the
importance of individualizing exercise prescriptions, particularly for inactive populations, in
order to maximize psychological variables such as positive core affect and enjoyment of
exercise, in order to promote adherence to programs13, 49.
Both core affect (pleasure/displeasure) and enjoyment of exercise have been shown to be
important psychological variables associated with why individuals choose to participate in or
maintain an exercise program50-55. However, hedonic responses (liking/enjoyment of an activity)
do not consider all aspects of the reward/motivation neurological decision-making process56. To
be specific, when two activities are liked or enjoyed the same, other factors must contribute to
the decision-making process, resulting in the choice to participate in one behavior over the other.
6
Thus, research suggests when given the choice between two equally liked or enjoyed activities,
individuals typically participant in the activity they prefer (want) to do22.
Preference for Activities
While hedonic responses are immediate, non-cognitive appraisals of one’s environment,
preferences rely heavily on the value of rewards associated with an activity as well as additional
perceptions and considerations of one’s surroundings56. Although both constructs, hedonic
responses and preferences, relate to the same overall neurological process that ultimately
attempts to evaluate the incentive value of a given behavior, two separate neurological pathways
regulate them. Whereas evidence suggests that hedonic responses are a result of opioid and
Benzodiaxepine agonist pathways, preferences are suggested to be driven by the
Mesotelencephalic Dopamine system56. Although previous taste reactivity studies have
demonstrated that these systems are independent, both neurological pathways are involved in
one’s “reward pathway” and contribute to an individual’s decision-making process and overall
behavioral choices. Considering the neurological research surrounding these psychological
constructs, the choice to watch television rather than exercise during available leisure time may
be explained through reward schedules. That is, television viewing offers immediate rewards
(perceived as fun, relaxing, and distracting from daily stressors). Conversely, the immediate
consequences of exercise are often perceived negatively by insufficiently active individuals (e.g.
rapid heart rate (HR), sweating, shortness of breath, fatigue), whereas the more rewarding
aspects (e.g. weight loss, increased muscle mass) are delayed.
Accessibility of activities is also thought to influence one’s preferences57, 58. While most
individuals have high accessibility to sedentary behaviors in their homes and work settings,
7
exercise typically requires additional travel. Even if individuals have immediate access to
exercise, such as walking around their neighborhood, other barriers to exercise exist, such as the
need to change clothing and taking time to shower afterwards. These additional barriers may
serve to reduce the reinforcing value of exercise for inactive populations. Evidence from
previous behavioral research suggests that individuals will continue to choose highly desirable
sedentary behaviors over physically active behaviors until access to those sedentary behaviors is
reduced and access to PA is increased22, 59. These findings serve to explain the overwhelming
participation in sedentary behaviors seen among U.S. adults. Furthermore, given that a variety of
elements contribute to behavioral choices, these findings support other models, such as the
Strength Model60, 61, which explains additional factors that contribute to one’s decision-making
process. Specifically, the Strength Model describes how an individual’s ability to self-regulate
their behavior draws energy from a central and limited resource. Throughout the day, as
individuals make decisions, particularly those that require self-control (e.g. choosing not to eat a
piece of cake at the work social for diet purposes), their ability to self-regulate diminishes. This
phenomenon is called ego depletion62, 63 and it has been suggested that the best way to replenish
this self-regulatory resource is rest and to restore energy levels64, 65. This model helps explain
why some individuals make the decision to sit on the couch after a long day of work instead of
being physically active despite knowing the physiological and psychological benefits of exercise.
Given the link between preference and behavioral choices, recent studies have
investigated the relationship between exercise-related behavioral decisions and related topics
including preferred exercise modality66, 67 and preferred exercise intensity68. Most recently, a
study68 used a behavior-choice paradigm approach to examine preference for self-selected
exercise intensity versus two imposed exercise intensity conditions. This research is timely given
8
that recent studies have suggested self-selection of exercise intensity promotes adherence to
exercise programs51, 69 as well as more positive in-task affective responses70. Results from the
behavioral choice paradigm showed that self-selected exercise intensity resulted in greater
preference for exercise, which may also have applications for future PA interventions as
preference has been used as a proxy for future behavior71. However, more research is warranted
given that exercise professionals are still searching for ways to make the exercise experience
even more desirable in order to help combat the appeal of sedentary behaviors.
Television Viewing and the Exercise Experience
Given that preferences are highly susceptible to change given one’s environment and
perceptions, finding effective ways to make the exercise experience more pleasurable and
enjoyable would likely influence an individual’s preference for PA. Previous studies have
examined the effects of exercise modality, exercise intensity, and exercise environments72, 73 on
psychological responses to exercise. These results suggests that exercising outdoors74, 75, in
groups76 and while listening to music77, 78 have positive effects on affective responses,
enjoyment, and preference for exercise. Although these approaches have been applied in various
settings to improve exercise enjoyment, they do not address the problem of seated television
viewing being a more reinforcing behavior to participate in. To address this limitation, a small,
but growing body of literature has addressed the impact of combining exercise with television
viewing, in order to improve the exercise experience. In theory, if this combination of behaviors
enhances the reinforcing value of exercise, it could translate to increased adherence to exercise.
Previous attempts at combining television viewing and exercise include contingency
protocols which requiring participants to exercise in order to obtain access to television viewing.
9
A previous study observed small increases in PA levels (approximately one hour per week) as
well as reductions in television viewing time (approximately 19 hours per week)79, unfortunately,
the increase in PA observed in this study falls short of national PA guidelines. In another attempt
to combine television viewing and exercise, Steeves et al.80, 81 used the novel approach of
encouraging stepping in place during commercial breaks and found that energy expenditure
increased to similar degrees as those who were given a 30-minute outdoor walking exercise
prescription. Enjoyment of exercise was measured using a 10-centimeter visual analog scale at
baseline, three-months, and six-months and increased similarly in both groups throughout the
intervention. Nonetheless, this study encouraged exercise during commercial breaks and not
while viewing desired television programs.
To date, only a few studies have attempted to directly determine the independent effects
of television program viewing on psychological responses during an exercise bout. Privitera et
al.82 attempted to examine the effects of television viewing during exercise on mood in college
students. The results suggest that an enjoyable distraction such as television viewing during
exercise enhances pre-post exercise ratings of pleasant mood compared to other exercise and
sedentary conditions. However, this study has several notable limitations, such that, an incorrect
tool was used to assess mood. The tool used (the Affect Grid83) in fact measures affective
responses, not mood. Given the proposed rebound effect of affective responses immediately
following exercise84, the lack of in-task measurements is not representative of the effects
television viewing has on affective responses during exercise. Two additional studies performed
in our laboratory have examined the independent effects of imposed and self-selected television
programs on enjoyment of exercise (assessed by the Physical Activity Enjoyment Scale85
(PACES)). These studies suggest that enjoyment of exercise is higher during exercise with
10
television viewing compared to exercise without television viewing86, despite whether the
content on the television during exercise was self-selected or chosen for them87. These findings
support the notion of incorporating television viewing (the most common leisure time activity)
with exercise to increase hedonic responses during exercise. However, it is not known if
television viewing during exercise can also alter other psychological variables associated with
future exercise behaviors, such as preference.
Statement of the Problem
It is essential that scientists find ways to increase participation in PA and exercise among
the general public. Findings from the Obesity-Related Behavioral Intervention Trials12
specifically call for phase I and II, theoretically based, pilot data targeting the foundations of
behavior change in order to promote the success of future, phase III efficiency trials/behavioral
interventions. While the HTM provides a foundation for behavioral exercise studies, the theory
does not fully explain behavioral choices, especially when faced with other attractive options. An
innovative approach to this problem is to pair exercise with one of its most prominent behavioral
competitors, seated television viewing, to enhance positive hedonic (core affect, enjoyment) and
preference responses. It is hypothesized that in doing so, the combination of television viewing
and exercise yields improvements in affect, enjoyment, and preference for exercise, compared to
exercising with no television. Additionally, it is important to determine whether such responses
will translate into observable exercise behavior, such as increases in treadmill walking time,
when other factors are held constant.
11
Statement of the Purpose
This study has two primary objectives. The first objective is to determine how television
viewing impacts relevant psychological constructs during exercise. It is hypothesized that, within
a behavioral choice paradigm68, 88, exercise paired with television viewing will yield more
positive affective responses and be rated as a more preferable activity, compared to exercise with
no television. The second objective is to determine the impact of television viewing on
observable exercise behavior. It is hypothesized that self-selected walking duration will be
longer during television viewing compared to walking without television.
Significance of the Study
Given that adherence to exercise programs is a problem in behavioral interventions,
finding ways to alter the exercise experience in order to enhance psychological responses may be
beneficial. If television viewing during exercise results in positive changes in psychological
responses associated with exercise behavior (in-task affect, enjoyment of exercise and preference
for exercise) such findings would warrant further exploration within behavioral interventions to
test the impact of explicitly instructing participants to exercise while watching television, rather
than instead of watching television. Additionally, this will be the first study to test whether the
combination of exercise and television viewing will produce positive changes in a behavioral
outcome (i.e. treadmill walking time). If the hypothesis is correct, it could lend additional
support for implementing television viewing in exercise programs.
12
CHAPTER II
Review of the Literature
13
Theoretical Framework
Considering the vital role that PA plays in human health, there is a need to identify
factors associated with one’s choice to participate (or not participate) in PA89. The HTM43
provides the theoretical framework to help explain PA related behavioral choices. This theory
states that the human emotional experience ranges from good to bad, and in an effort to maintain
a good emotional state; individuals pursue pleasurable activities and avoid those that are
unpleasurable. Much of the literature surrounding this theory has been applied to excessive
eating behaviors90, shopping habits91 and drug addictions92. Findings from these studies help
explain why, despite negative consequences such as weight gain, financial debt and
psychological/physical addiction, individuals still participate in them.
In applying the HTM to PA behaviors, exercise has traditionally been thought of as an
activity that makes individuals feel good. The physiological reasoning behind this viewpoint is
that exercise results in the release of brain-derived neurotropic factor and endorphins such as
dopamine that when released, increase positive mood and sensations of euphoria93-95.
Additionally, regular exercise participation has been shown to attenuate stress related
neuroendocrine reactivity, resulting in reductions of tension and anxiety-inducing hormones
(adrenaline and cortisol)96, 97. The psychological reasoning behind this viewpoint is based on
more than 40 years of research examining psychological responses to exercise. Early research
suggested that approximately 80-90% of individuals reported that exercise makes them feel
better98. However, based on the HTM, low PA participation rates among U.S. adults contradict
the notion that exercise makes the majority of individuals feel good. It is now understood that
due to methodological errors implemented in these early studies, important in-task feelings were
largely overlooked and in fact, individuals do not feel good during exercise, particularly at higher
14
exercise intensities48, 84, 99. These findings are more reasonable given that inverse relationships
between hedonic responses and behavior are not generally seen among other activities that are
considered to be pleasurable. For example, individuals do not typically avoid food when hungry.
This is because, for most, fulfilling such wants/needs like hunger brings feelings of pleasure and
satisfaction, encouraging further participation in that behavior. Thus, accurately determining how
exercise makes individuals feel is essential for explaining related behavioral choices.
Affective Responses
In an attempt to better understand how exercise makes people feel, researchers have
revisited the initial claims that individuals feel good during exercise due to the contradictions
between this claim and observable PA behavior. Backhouse et al.84 was one of the first to address
several issues with early exercise psychology research including 1) the oversight of directional
changes in affective responses, 2) improper measurement tools, 3) improper measurement time
points, and 4) improper data analyses techniques.
First, early investigations of psychological variables and exercise were primarily
concerned with positive changes in psychological states. Thus, changes in negative
psychological responses were largely overlooked, partially due to the use of surveys or
questionnaires what could not detect negative changes, resulting in overgeneralized conclusions
that exercise generally promoted positive feelings. To combat this, Watson and Tellegens100
created the Circumplex Model which provides the ability to track both positive and negative
changes, as well as the absence of change. Specifically, the Circumplex Model incorporates
measure of core affect, defined as the most basic element of all valenced responses (e.g.
pleasure/displeasure). Related to, but not to be mistaken for core affect, are the distinctly
15
different constructs emotions and moods, which have also been examined throughout the
literature. Unfortunately, these terms have been incorrectly and interchangeably used throughout
the exercise psychology literature to describe core affect. Specifically, core affective responses
are immediate and do not rely upon cognitive appraisal of one’s environment47. Emotions are
complex, short-lived, intense feelings typically targeted at something or someone and do require
cognitive appraisal of the environment while moods do require cognitive appraisal, are longer-
lived, less intense than emotions, and typically do not have a specific target101. Affective
responses have become a primary variable of interest in many exercise psychology studies, as
they are the best measure of in-task feelings. In addition to affective responses, the Circumplex
Model also assesses one’s state of arousal (e.g., bored, uninterested, excited, or engaged).
The Circumplex Model combines ratings from the Feeling Scale102, an 11-point, single
item scale, ranging from -5 (very bad) to 5 (very good) with 0 (neutral) as a midpoint, and the
Felt Arousal Scale103, a 6-point single item scale ranging from 1 (low arousal) to 6 (high
arousal). When combined, these two scales allow for an orthogonal and bipolar measurement of
valenced responses. Four quadrants can be created from these responses: 1) high activation and
pleasure, 2) low activation and pleasure, 3) high activation and displeasure, and 4) low activation
and displeasure. Resting, pre-and post-exercise as well as in-task measurements are plotted on
the model to map an individual’s psychological state throughout exercise testing, helping combat
the issue of only observing positive changes in psychological responses associated with exercise.
Secondly, but potentially the most common error of the early exercise psychology
literature, was that many of these studies only obtained measurements pre-and post-exercise. It is
now understood that these measurement time points do not accurately reflect how an individual
feels during exercise. To date, a variety of evidence suggests there is a rebound effect,
16
particularly in positive affect, following exercise104-106. Thus, it is not the act of exercise, but the
end of exercise, that results in the positive affective responses. Studies applying measurements of
in-task affect have largely demonstrated that affective responses are not unanimously positive
during exercise and factors such as exercise intensity greatly influence these psychological
responses to an acute exercise bout. This is concerning considering that exercise intensity has
been found to be the component of an exercise prescriptions most strongly related to exercise
adherence rates70, 107, 108. The specifics of these responses are explained by the Dual Mode
Model109.
The Dual Mode Model states that exercise intensities below VT generally result in
positive affective responses, allowing individuals to focus their attention on cues from their
surrounding environment. As exercise intensities approach VT, affective responses become
highly variable. However, once VT is surpassed, affective responses nearly always become more
negative, as individuals begin to direct their attention to the unpleasurable interoceptive cues
caused by the physiological disruption of metabolic homeostasis (increased HR, breathing rate,
sweating, soreness, etc.). This response is unique to core affect as traditional exercise stress
markers such as rating of perceived exertion (RPE) and HR typically demonstrate a continuous,
positive response to increasing exercise work rates. The Dual Mode Model supports prescribing
exercise using percentages of an individual’s VT instead of more commonly used variables such
as percent of maximal oxygen consumption or HR, in order to help avoid the negative
psychological responses seen following the disruption of metabolic homeostasis. However,
although exercise intensities below one’s VT generally result in positive affective responses, if
exercise intensities are too low, desired benefits such as weight loss or increased muscle mass
may not occur in a timely manner which could result in participants dropping out of exercise
17
programs. Thus, individualizing exercise prescriptions not only to maximize desired physical
outcomes, but also to reduce negative psychological constructs becomes imperative.
While the Dual Mode Model has helped explain why findings from previous studies that
only utilized pre-and post-exercise measurements have not completely translated into observable
exercise behavior, it has also highlighted the high degree of inter-individual variability in
affective responses, particularly close to the VT47. Such differences in affective responses among
individuals at a given exercise intensity may explain why some maintain exercise programs
while others do not. An individual’s preference for and tolerance of exercise intensities are
examples of cognitive factors that may contribute to this inter-individual variability in affective
responses. Additionally, as both are related to exercise frequency49, 110, these factors help explain
why individuals who have a greater preference for and tolerance of higher intensity exercise (e.g.
athletes) continue to participate in various activities while others (e.g. insufficiently active
individuals) do not despite the relatively unanimous reports of decreased pleasure at higher
intensities109, 111. Body weight is another factor which may contribute to differences in affective
responses at a given work rate70, 112, 113. In a study by Ekkekakis et al.,70 normal weight (BMI <25
kg/m2) and overweight (BMI ≥25 kg/m2) women were asked to exercise at an intensity only 10%
greater than their preferred, self-selected pace. Overweight women had significantly lower
affective responses compared to their self-selected exercise bout, whereas normal weight women
exhibited no differences in affective responses. Considering that individuals tend to self-select
exercise intensities that are slightly below their VT111, 114, 115, it is possible that the imposed 10%
increase in exercise intensity during this study exceeded their VT, intensifying unpleasurable
feelings among the overweight women. Despite what causes the variability in affective responses
observed near work rates associated with an individual’s VT, the inter-individual variability in
18
affective responses has also been problematic for drawing appropriate research conclusions,
particularly when examining data at the group level48, 116, 117.
For example, in a study by Van Landuynt and colleagues48, participants cycled for 30-
minutes at 60% of estimated maximal oxygen consumption while the Feeling Scale, Felt Arousal
Scale, HR and RPE were recorded at minutes 7, 12, 17, 22 and 27. Data were analyzed at the
group and individual level. The group analysis revealed no change in mean affective responses
during exercise; however, this analysis masked important individual responses. Specifically, only
12.7% of the sample reported no changes on the Feeling Scale, while 33.3% reported positive
responses and 22.2% had negative responses to exercise. These findings demonstrate the
importance of proper data analysis techniques when assessing psychological responses to
exercise. In summary, improper methodological and statistical analysis of previous research has
led to overgeneralized conclusions suggesting that exercise makes individuals feel good.
Through more diligent and appropriate research designs, recent studies have provided a more
accurate depiction of how exercise influences psychological constructs, particularly core affect,
which have been shown to be associated with future behavior habits.
Specifically, affective responses during moderate-intensity exercise has been shown to be
predictive of self-reported PA levels six and 12 months after an exercise intervention51. One
study showed that a one unit increase in core affect was associated with an additional 38 minutes
of self-reported PA per week at six-months and 41 minutes of self-reported PA per week at 12-
months51. Additionally, a one-unit increase in in-task affective response has also been shown to
be both longitudinally (an additional 15 minutes per week) and cross-sectionally (an additional
27-29 minutes per week) associated with self-reported PA levels52. Such associations between
affective responses and PA behavior have also been observed in children55. Promoting changes
19
in the exercise environment to promote positive affective responses could translate to changes in
PA behavior that accumulates enough over time to have clinically significant health benefits.
Enjoyment of Exercise
In addition to in-task affective responses, enjoyment of exercise has also been shown to
be an important variable linked to exercise adherence118-122. Moreover, lack of enjoyment is a
commonly reported barrier to exercise42, 123. Enjoyment is defined as “a positive emotion, a
positive affective state” and is thought to be one dimension of intrinsic motivation118, a necessary
factor in the maintenance of regular exercise routines28. Thus, the more enjoyable an individual
finds an activity to be, the more likely they are to participate in it. To date, there is only one
validated survey that assesses enjoyment of exercise, the PACES85. This survey consists of 18-
items that are rated on a seven-point Likert scale with opposite descriptions at each end of the
scale (1=I enjoyed it, or 7=I hated it).
The earliest study examining the importance of enjoyment of exercise dates back to 1979
when Perrin et al.123 surveyed 769 Ontario residents to determine reasons for PA or physical
inactivity as well as related psychological factors. Overall, 92% of participants surveyed reported
that enjoyment of exercise was the most influential factor when deciding to participate in
exercise, ranking higher than factors such as health or weight control. More recently, studies
have reported that exercise enjoyment is a significant predictor of an individual’s participation in
moderate-to-vigorous intensity exercise. Specifically, Salmon et al.89 reported that those
expressing high levels of enjoyment of walking, based on reports from a five-point Likert scale
(1=no enjoyment, 5=a lot of enjoyment), were three times more likely to meet PA guidelines
compared to those who reported less enjoyment. Papandonatos et al.54 also found that enjoyment
20
of exercise and other exercise-induced feelings were associated with PA levels throughout a 12-
month intervention.
A variety of approaches have been attempted in order to increase enjoyment of exercise.
Several studies have shown that placing mirrors in exercise rooms72, 73, exercising outdoors74, 75,
exercising in groups76, and listening to music during exercise77, 78 can increase one’s enjoyment
of an acute exercise bout. Promoting enjoyment of exercise is important considering that,
according to the HTM, when individuals are able to associate an activity with a
pleasurable/enjoyable response, they are more likely to continue participation in that activity.
However, despite the strong association between enjoyment and affective responses with
exercise adherence, they do not fully explain how individuals choose between two activities that
are equally liked. Thus, other influential factors outside of basic hedonic responses, such as how
much an individual likes or enjoys an activity, must contribute to an individual’s behavioral
decision-making process.
Preference, Affective Responses and Enjoyment of Exercise
Behavioral economics is a conceptual model which, in addition to the HTM, allows for a
better understanding of factors associated with one’s decision-making process124. Research in
this area has shown that when two activities are enjoyed equally, an individual will participate in
the one they want (prefer) to do56. For the purposes of this study, preference will be defined as
one’s predisposition to select a particular activity over another110. Like hedonic responses,
preferences have also been used as a proxy for future behavior71, however these constructs are
distinctly different. The differences between liking (hedonic) and wanting (preference)
constructs have been primarily investigated in nutrition research56. Studies in this field suggest
21
that liking and wanting are independent from one another and occur via two distinct neurological
processes56, 125. Although strongly related to wanting, liking an activity is not always enough to
prompt behavior, and thus the two constructs are not equal.
Unlike hedonic responses, preferences account for the reinforcing value of a behavior,
resulting in a stronger association with one’s choice to participate or not participate in a
particular activity. In general, the reinforcing value of an activity is defined by the accessibility
and rewards associated with a particular activity. When activities are more accessible, they
require less work and effort to participate in them. Additionally, the rewards individuals
associate with a particular behavior become positive reinforcers and thus, encourage continued
involvement in the given behavior58. In regards to PA and sedentary behaviors, sedentary
activities are typically more accessible and rewarding. For example, while participation in some
PA requires individuals to travel to parks, trails, or fitness centers for most individuals, sedentary
activities such as watching television or playing video games can be performed right in the
home. For those who have access to in-home exercise equipment or safe neighborhoods to walk
in, participation in PA, unlike sedentary activities, still requires additional work (e.g. changing
clothes and shoes), reducing the overall reinforcing value of PA. In regards to rewards, for many
insufficiently active adults, sedentary behaviors are typically associated with instantaneous
benefits such as relaxation and comfort. PA on the other hand usually results in immediate
discomfort (e.g. sweating) and has delayed rewards (e.g. weight loss) that only come if
participation is continued for these individuals. As seen with hedonic responses, factors such as
body weight may further exacerbate sensations of discomfort, lessening the reinforcing value of
being physically active88. Thus, the high reinforcing value of sedentary behaviors, help explain
why many individuals choose to participate in them instead of PA during their leisure time58, 88.
22
To further examine this relationship, several studies have manipulated the accessibility of
sedentary and physical activities in order to determine how these influences an individual’s
behavioral choices. These studies have demonstrated that when given equal opportunity (access)
to be sedentary or physically active, individuals choose to participate in sedentary behaviors57, 58,
88, 126. As predicted, individuals also choose sedentary behaviors when access to PA is reduced57.
However, when access to sedentary activities is reduced, a change in behavior towards PA is
observed as individual’s behavioral choices switch57, 88. Specifically Raynor et al.57, found that
sedentary activities were preferred over equally-liked PA until proximity of sedentary activities
was reduced and the proximity of PA was increased. Unfortunately, in modern society, in an
attempt to maximize comfort and convenience, most social environments provide high
accessibility to sedentary activities through chairs, couches, trolleys, elevators, moving
walkways in airports, etc., which further promotes sedentary behaviors rather than PA.
Given that these environments continue to develop in a manner that supports sedentary
behaviors rather than making them less accessible, a more feasible approach may be to increase
the reinforcing value of PA to encourage behavior. To date, preferences for exercise
environment127, time of day128, modality66, 67 and intensity70 have all been shown to influence
one’s exercise experience. Most recently, Williams and Raynor68 examined how self-selected
and imposed exercise intensities affected relative preference using a behavioral-choice paradigm
approach. This approach asked individuals to perform three randomized 1/3-mile walking bouts
on the treadmill at 1) their self-selected intensity, 2) an imposed intensity (20% higher than the
self-selected pace) or 3) a yoked intensity. The yoked intensity was identical to the self-selected
pace; however, participants were told it was a different intensity. Participants were blinded to the
actual speed and incline of the treadmill during all conditions. In between walking bouts,
23
individuals were seated and performed a five-minute paperclip-sorting task. This sedentary
activity served as a washout period between the walking bouts and exposed participants to the
sedentary activity they would be questioned about subsequently. Following all three walking and
sedentary paperclip-sorting bouts, participants completed a preference survey. This survey asked
individuals to choose if they would prefer to walk one mile distance under each of the three
conditions (self-selected, imposed, yoked) or sort paperclips for a given about of time (ranging
from 2-20 minutes). The primary findings from this study were that self-selected exercise
intensities promoted the greatest preference for exercise, followed by the yoked-self-selected and
finally the imposed intensity conditions. The behavioral choice paradigm approach used in this
study provides researchers the ability to examine the influence a particular exercise environment
on psychological constructs. Additionally, the behavioral choice paradigm also provides a
systematic approach that reduces social bias to provide a more accurate depiction of real life
choices within the limits of a tightly controlled laboratory-based study. Thus, further research is
warranted utilizing approaches such as the behavioral choice paradigm to determine how one’s
exercise environment influences their preference for exercise. By attempting to improve hedonic
responses and preference for exercise through changes to the exercise environment, health care
professionals can help combat the appeal of sedentary behaviors.
It is important to note that not all sedentary behaviors are equally desirable or compete
with exercise preferences similarly. Specifically, highly desired sedentary activities compete
with exercise much more than less desired sedentary activities126. Thus, recent studies have
examined various intervention techniques in an attempt to decrease time spent in highly desired
sedentary activities (such as television watching) and promote exercise behaviors. For example,
Raynor et al.129 compared a reduced television viewing and increased PA prescription to a
24
traditional PA prescription during an 8-week weight loss intervention in obese adults.
Throughout the intervention, the group that received both the reduced television and increased
PA prescription decreased television viewing (approximately 16.5 hours per week), with no
changes in moderate-to-vigorous PA and a reasonably small (1.5%) increase in light PA
compared to baseline. Faith et al.79 also reported statistically significant reductions in television
viewing time (∼19 hours per week) and increases in PA (approximately one hour per week)
when using a closed-loop contingency cycling protocol in which children were rewarded with
television viewing if they simultaneously pedaled the bike. Other findings using a contingency
protocol support these findings of increasing PA to obtain highly desired sedentary behaviors
such as television viewing126, 130, supporting the idea that sedentary behaviors can be used to
reinforce PA58. Thus, it may be advantageous to combine one of the most highly desired
sedentary activities (i.e., television viewing) with exercise to improve the exercise experience.
This is a fundamentally different approach than using television viewing as an incentive for
exercise participation or withholding television as punishment for lack of exercise participation.
Few studies have looked at the psychological and physiological effects of combining these
activities.
In the first attempt, Anessi et al.131 conducted a 14-week study that tested the effects of
various exercise entertainment modalities on distraction during exercise, exercise adherence, and
physical outcomes. Participants were encouraged to exercise according to the national aerobic
PA recommendations and were randomized to one of three exercise conditions (music,
television, or combined entertainment). The music group was provided a radio cassette player
that allowed them to listen to the radio or play cassette tapes. The television group viewed one of
four non-preferred pre-set television channels on mounted televisions while the combined
25
entertainment group had a personal television embedded in their exercise equipment with access
to 62 channels. This group also had access to the radio, CDs or cassette tapes. Results showed
that the combined entertainment group had significantly lower dropout and showed a trend
towards higher attendance. Participants in this group also performed significantly longer exercise
sessions. Despite these beneficial findings, the study design does not allow us to determine
which mode of entertainment in the combined group (television or radio) resulted in the
increased exercise frequency and duration observed among participants.
In 2012, Casiolio132 examined whether television viewing during a 15-minute bout of
treadmill walking promoted greater dissociation from exercise stimuli or increased walking
distance compared to a 15-minute bout of treadmill walking without television viewing. No
differences in walking distance were observed between exercise conditions, however, television
viewing resulted in significantly more external thoughts compared to the non-television
condition as measured by the Associative Thought Scale133. These findings were limited by the
15-minute time restriction for each exercise bout. The authors suggest that television viewing
during an unlimited exercise bout may have resulted in increased walking distance.
Privitera et al.82 also attempted to determine how television viewing impacts the exercise
experience. The Affect Grid83 was used to determine pre- and post-changes in mood following a
10-minute bout of treadmill walking while watching a 10-minute clip of the television sitcom,
Two and a Half Men. Both exercise with and without television viewing resulted in significant
improvement in pleasant mood, however these improvements were enhanced during the
television viewing condition. Although this study was the first to show the independent effects of
television viewing, it is limited in that the Affect Grid does not actually measure mood but
instead it measures core affect. Additionally, as previously explained, pre-and post-exercise
26
measurements are an inappropriate study design for making any conclusions regarding the
effects of television viewing on affective responses during exercise.
More recently, a six-month PA intervention80, 81, 134 found that stepping in place during
television commercial breaks resulted in similar increases in enjoyment of exercise and energy
expenditure compared to 30-minutes of outdoor walking. However, considering that exercise
was performed during commercial breaks instead of during the television program itself, it
cannot be determined if television viewing was responsible for the increases in enjoyment
throughout the intervention. Recent laboratory studies86, 87 have also examined the effects of
television viewing during 30-minute bouts of moderate-intensity exercises. Overstreet et al.86
reported increased enjoyment of exercise in insufficiently active college students during cycling
exercise while watching a nature program (British Broadcasting Channel’s nature documentary
Life television program entitled “Challenges of Life”) compared to cycling without any
television stimulus. Interestingly, intrinsic motivation and mean Feeling Scale values were
correlated with enjoyment for both conditions. Rider et al.87 reported similar findings in a cohort
of insufficiently active adults (30-65 years). This study also included a self-selected television
program condition, but found no significant differences in enjoyment of exercise between the
imposed nature program and self-selected television conditions. Enjoyment of exercise while
viewing both television conditions was significantly higher than enjoyment of exercise without
any television. These findings support the notion of incorporating the most common sedentary
leisure time activity (i.e. television viewing), with exercise to increase one’s experience and
potentially promote psychological variables associated with future exercise behaviors. However,
these two studies by Overstreet et al.86 and Rider et al.87 have only utilized hedonic responses
and those that have attempted to examine behavioral changes have been limited by exposure
27
periods that were too short to promote behavioral differences.
Summary
Given that the decision making process can be strongly influenced by one’s
environment21, 22, previous efforts have been made to increase the desirability of exercise
environments to help promote PA behaviors120, 135, 136. Currently, national organizations such as
the ACSM are encouraging that exercise not be prescribed as a “one size fits all”, but rather that
exercise professionals focus on individual preferences for all components of the exercise
prescription (frequency, intensity, time and type) in order to promote adherence13, 135. Thus, it
becomes important to determine how to best alter the exercise experience to enhance positive
psychological variables and promote adequate participation in PA to help individuals obtain
substantial health benefits associated with exercise137. As access to favorite television shows
through media outlets such as Netflix (Los Gatos, California, U.S.A.) and Amazon Prime
(Amazon, Seattle, Washington, U.S.A.) rise, along with the popularity of trends such as binge-
watching of television, so will the need for exercise professionals to understand the influence of
hedonic responses and preferences on an individual’s choice to participate in sedentary or PA
behaviors.
Previous literature supports the use of television viewing during exercise to promote
positive changes in hedonic responses. However, it has yet to be determined how television
viewing during exercise influences preference for exercise. Additionally, previous studies have
not implemented frequent enough measurements of in-task affective responses to accurately
describe how television viewing may alter such feelings. Given that preference and hedonic
responses are two separate cognitive processes56, the effects of the exercise environment on both
28
constructs must be considered, since hedonic responses to an activity do not readily translate to
preference for the same activity.
Since preferences for exercise may vary between individuals138, 139, the purpose of this
project was to determine how a positively valenced stimuli (television viewing) alters preference
for exercise, enjoyment of exercise and in-task affective responses. Additionally, it was an aim
of this study to determine how combining television viewing with exercise would impact self-
selected walking duration (treadmill walking time) when individuals are given equal access to
seated television viewing.
29
CHAPTER III
Manuscript
30
Abstract
Purpose: To determine the effects of television viewing during exercise on 1) preference for
exercise and 2) treadmill walking time. Methods: Twenty-five insufficiently active adults
(mean±standard deviation; age: 46±12 years; Body mass index: 31±5 kilogram/squared meter
(kg/m2) were recruited for this study. In part 1, participants performed three randomized 1/3-mile
walking bouts at an intensity equivalent to 70% of their oxygen consumption at ventilatory
threshold (VO2-at-VT). During these exercise bouts, individuals viewed 1) their favorite
television program (FavTV), 2) a standardized nature program (NatTV) or 3) no-TV program
(NoTV). A behavioral choice paradigm was used to assess preference for exercising with each
television condition. In part two, participants completed two randomized 60-minute visits in
which they were asked to walk at 70% of VO2-at-VT for 10-minutes under FavTV or NoTV
conditions. After 10 minutes, participants could choose to continue exercising under the current
TV condition or stop exercising and watch television while seated. Participants were allowed to
switch between exercise and rest as they desired during the remaining 50 minutes. Results:
Preference for exercise was greater during FavTV and NatTV versus NoTV (p<0.05), with no
differences between FavTV and NatTV (p=0.132). Despite difference in preferences for exercise,
no significant difference in treadmill walking time was observed for FavTV vs NoTV (50.0
versus 44.7 minutes, respectively; p=0.102). Conclusions: This study provides empirical
evidence that inactive individuals prefer walking with television viewing over walking with no
television. Further research is needed to determine if active television viewing can translate to
observable changes in exercise behaviors.
Key words: Exercise, behavior change, entertainment, physical activity
31
Introduction
The low prevalence of U.S. adults who self report meeting the national PA
recommendations continues to be a concern for health professionals, particularly as knowledge
concerning the health benefits associated with PA140 and the health hazards of physical
inactivity141 grows. Recently, national organizations have begun encouraging health
professionals to individualize exercise programs in order to promote positive psychological
responses, which may, in turn, encourage exercise adherence13, 49. Thus, if more attention is
placed on making exercise more pleasurable and enjoyable, individuals might be more inclined
to participate in and maintain regular exercise routines.
The Hedonic Theory of Motivation (HTM) provides a theoretical framework that
attempts to explain the importance psychological constructs, such as pleasure and enjoyment, in
regards to future exercise behavior. This theory states that individuals pursue activities that make
them feel good and avoid those that make them feel bad43. Hedonic responses including in-task
affect (e.g. pleasure/displeasure), the most basic element of all valenced responses142, and
enjoyment of exercise (a positive emotion that stems from a positive affective state118), have
been shown to be predictive of future exercise behaviors21, 51, 52, 121, 123, 137. Specifically, affective
responses during an acute moderate-intensity exercise bout have been shown to be predictive of
self-reported exercise participation six-and-12 months later51, 52. Additionally, affective
responses during a single bout of moderate-intensity exercise have been shown to also be
significantly correlated with total self-reported PA minutes, and minutes spent in vigorous-
intensity PA three-months post the completion of an exercise intervention53. In regards to
enjoyment, Papandonatos et al.54 reported that enjoyment of exercise was associated with self-
reported PA levels during a 12-month intervention. Furthermore, a study by Salmon et al.137
32
demonstrated that individuals who reported high levels of enjoyment of walking were three times
more likely to meet PA guidelines compared to those who reported low levels of walking
enjoyment.
Despite the relationship of these hedonic responses and future exercise behavior, there
has been a discrepancy between early exercise psychology research findings which state that
exercise makes most individuals feel good98, 143 and more recent research. The early studies that
reported favorable changes in psychological variables during acute exercise bouts were limited
by improper methodological techniques84. While these early studies overwhelmingly suggested
that exercise makes individuals feel good, many of these studies only measured psychological
responses pre- and post-exercise, and not during exercise. More recent research has demonstrated
that this methodological approach may have resulted in oversimplified conclusions that exercise
largely promotes positive feelings amongst the general public. As explained by the Dual Mode
Model50, it is now known that exercise does not always result in positive affective responses. The
Dual Mode Model suggests that while exercise intensities below one’s VT commonly result in
positive affective responses, these responses become more negative for most individuals once
VT is surpassed. This decline in affective responses is in part due to individuals directing their
focus on the disruption of metabolic homeostasis during high intensity exercise. However, even
moderate-intensity exercise can result in negative affective responses for some people, as high
variability in inter-individual responses at exercise intensities near or at VT have been
observed48. Thus, pre-and post-exercise measurements do not accurately reflect how most
individual feels during exercise, but rather reflect a rebound in positive affect caused by the
cessation of exercise104-106. Despite an improved understanding of these psychological constructs,
affective responses may only explain 1-6% of the variance in exercise behaviors53. This suggests
33
that other mechanisms contribute to the interplay between psychological responses and long-
term behavior.
Preferences, defined as one’s predisposition to select a particular activity over another110,
may help further explain exercise-related behavioral choices. Preferences are highly influenced
by one’s environment as well as the rewards associated with participation in a given activity56.
Research suggests that when given equal access to sedentary (e.g. seated television viewing) or
physical activities (e.g. walking around one’s neighborhood), most individuals chose sedentary
behaviors57, 58, 88, 126. One influential factor contributing to an individual’s decision to be
physically active or inactive may be that sedentary activities such as seated television viewing
are highly rewarding (e.g. relaxation, comfort) while exercise typically imposes immediate,
uncomfortable responses (e.g. sweating, muscle discomfort). Additionally, the rewards
associated with exercise (e.g. weight loss, increased muscle mass) are delayed and typically only
come with long-term participation. Furthermore, while most sedentary behaviors are easily
accessible, exercise usually requires additional travel to gyms, parks, recreation centers, etc.
Even if individuals have immediate access to exercise, such as walking in their neighborhoods,
exercise requires additional efforts such as changing clothes/shoes and showering afterwards,
decreasing its reinforcing value of PA for many. This greater reinforcing value of sedentary
activities compared to PA may help explain why positive changes in affective responses and
enjoyment have not translated into sustained, observable exercise behaviors at the population
level.
The most common sedentary leisure time activity (hence potentially posing the most
competition to exercise) is television viewing. On average, U.S. adults spend approximately 53%
(2.77 hours) of their daily leisure time watching television29. With advancements in technology
34
including on-demand and on-the-go features, allowing individuals to choose when and where
they watch their favorite programs, television viewing has become accessible in most places. The
high accessibility and immediately rewarding sensations associated with seated television
viewing has not only led to it being the most common sedentary leisure time activity, but has
also resulted in a new cultural phenomenon, “binge-watching”. Binge-watching, the act of
watching multiple television programs in rapid succession144, has become increasingly popular in
the past decade as Netflix and similar media services have become more readily available. This
trend is concerning since extended periods of time seated in front of the television have been
associated with increased health risks such as obesity, type II diabetes, cardiovascular disease
and all-cause mortality39. While previous researchers have attempted to increase PA by reducing
or removing television-viewing time, they have been largely unsuccessful57, 79. A promising
approach to promoting exercise may be combining two behaviors: television viewing and
exercise. Combining the most common sedentary behavior with exercise not only reduces
potential barriers, as individuals are no longer required to choose between the two activities, but
it may also improve the overall reinforcing value of the exercise experience.
Recently, two studies combined television viewing with exercise to determine the
independent effects of television viewing on in-task affective responses and enjoyment of
exercise. Overstreet et al.86 demonstrated that enjoyment of exercise was higher during a 30-
minute cycling exercise bout while viewing a nature program, compared to exercise without
television viewing. Additionally, this study found that mean in-task affective responses were
correlated with enjoyment of exercise during each condition. A follow up study by Rider et al.87
added a favorite television condition and found that enjoyment of exercise was higher during
favorite and nature television program exercise conditions, compared to exercising without
35
television viewing. No differences in enjoyment of exercise were observed between the favorite
and nature television program exercise conditions. Findings from these studies support the idea
of combining the most common sedentary behavior, television viewing, with exercise in order to
promote hedonic responses associated with future exercise behaviors. However, the degree to
which television viewing during exercise may impact preferences for exercise is currently
unknown. Assessing this variable, which takes into consideration the reinforcing value of a
behavior, may provide deeper insights into exercise related behavioral choices.
Therefore, the current study had two aims. The first aim was to use a behavioral choice
paradigm to determine an individuals’ preference between three exercise conditions: exercising
while watching their favorite television program (FavTV), exercising while watching a nature
television program (NatTV), and exercising with no-television (NoTV). The second aim was to
compare treadmill walking time under two conditions (FavTV and NoTV).
Methods
Participants
Twenty-five insufficiently active adults (26-65 years of age) participated in this study
(Table 1). Being insufficiently active was defined as completing less than 150 minutes of
moderate-intensity or less than 75 minutes of vigorous-intensity PA as determined by the 2009
Behavioral Risk Factor Surveillance Systems Physical Activity Questionnaire145. A Health
History Questionnaire was administered to ensure participants were free of any contraindications
to exercise as outlined by the ACSM13 as well as any acute/chronic injury or physical limitations.
Additionally, in order to be eligible for the study, one of the individual’s three self-reported most
favorite television programs had to be available on either Amazon Prime or Netflix to ensure
36
access to the program during future visits. Participants were recruited by sending approved
emails, posting flyers on University and community bulletin boards, and by word of mouth.
Participants did not receive any incentives for their participation in the study. Written informed
consent was obtained prior to participation and the study was approved by the university’s
Institutional Review Board prior to starting.
Experimental overview
Eligible participants made four visits to the laboratory. The first visit included baseline
psychological trait questionnaires, anthropometric measurements, and a graded exercise
treadmill test. The second visit consisted of the behavioral choice paradigm to address the first
objective, to assess how different television conditions (FavTV, NatTV, NoTV) influence
preference for exercise as well as affective responses during exercise. This approach allows
researchers to examine the influence a particular exercise environment has on psychological
constructs while reducing social bias. The third and fourth visits (occurring in a randomized
order) participants were asked to exercise for a minimum of 10 minutes, after which they were
given a choice to continue exercising or to sit quietly, alternating between these behaviors as
desired during the remaining 50 minutes of each visit. During one of these visits, participants
viewed their FavTV despite the activity being performed (exercise or seated television viewing).
During the other visit, participants could only view their FavTV program while seated. During
all visits, participants were asked to refrain from using cell-phones, computers, books or any
form of entertainment other than the TV stimulus. All non-essential conversations were restricted
throughout the visits and any timepieces (clocks, timers, watches, etc.) were removed from sight.
37
Additionally, the digital display on the treadmill was covered during to prevent participants from
viewing the treadmill settings and exercise duration.
Procedures
Initial Assessment (Visit 1)
Anthropometric and Psychometric Assessments. After obtaining informed consent,
baseline trait questionnaires including the Preference and Tolerance for Intensity of Exercise
Questionnaire110 and the Behavioral Regulation in Exercise Questionnaire146 were administered
to determine potential influences on enjoyment or preference of exercise. Next, a Seca
stadiometer (Birmingham, United Kingdom) was used to measure height and a calibrated Health-
O-Meter digital scale (Boca Raton, Florida, U.S.A) was used to measure weight. For all
measurements, participants wore light clothing and were asked to remove their shoes or any
additional heavy objects from their pockets. A bioelectrical impedance analyzer (Omron,
Netherlands) was used to measure percent body fat.
Graded Exercise Test. Following all baseline measures, participants performed a graded
exercise test on a treadmill (Quinton Instrument Company, Bothell, WA, U.S.A.). Walking
speeds were held constant while the incline began at 0.0% and increased by 0.5% each minute
throughout the test. HR was continuously measured by a Polar HR monitor (Kempele, Finland)
and expired gasses were continuously monitored using a Parvomedics metabolic cart (Sandy,
Utah, U.S.A.). RPE was assessed using Borg’s 6-20 RPE Scale147 during the final 10 seconds of
each stage. The exercise test continued until volitional exhaustion. Peak oxygen consumption
(VO2peak) was considered to be the highest 1-minute average oxygen consumption value
associated with the highest work rate reached during the graded exercise test.
38
The software from the metabolic cart was used to identify a participant’s VO2peak and VT,
which was used to calculate an individual’s exercise work rate for the remaining visits (70% of
VO2-at-VT). This exercise intensity was chosen based on the Dual Mode Model, which suggests
that work rates below VT allow individuals to monitor the exercise bout under the various
television conditions with cognitive appraisal while work rates exceeding VT may direct
participant’s attention to the physiological cues associated with disruption of metabolic
homeostasis and away from the television programs.
Behavioral Choice Paradigm (Visit 2)
The methods described below have been previously published in a study that examined
the effects of imposed and self-selected exercise intensities on preferences and affective
response68. For clarity, Figure 1 outlines the timeline of events during Visit 2. During this visit,
participants performed three 1/3-mile exercise bouts (~seven minutes each) on the treadmill
(total distance=one mile). Each exercise bout was separated by a 5-minute sedentary task
(paperclip sorting). During this task, participants were asked to sort a variety of colored
paperclips into associated colored cups. The purpose of the one-mile walk and the paperclip
sorting tasks was to familiarize the participant with activities referred to on the behavioral choice
questionnaires that assessed preference for exercise. The order of the walking bouts (FavTV,
NatTV or NoTV) was randomly assigned using a random number generator program. During
FavTV, participants watched an episode of their preferred program designated during initial
eligibility screening. During NatTV, all participants viewed the same portion of the British
Broadcasting Company’s Life (Disc 1, Episode 1: Challenges of Life). This program was selected
as a means of reducing exposure to aversive themes (e.g. socio-political, religious, or upsetting
39
themes) which may influence psychological states during exercise82. Additionally, this program
has been previously used during treadmill walking exercise to reduce boredom148. During NoTV,
the television remained in view, but was turned off and covered to prevent any potential
reflection/mirror effect72, 73. During each bout, HR was continuously monitored while RPE and
affective responses (assed via the Feeling Scale) were measured immediately prior to exercise,
every 0.10-mile during exercise, and immediately following exercise. Upon completion of each
walking bout, participants were seated and completed the PACES to assess enjoyment of the
bout. Following the PACES, participants silently performed the paperclip sorting task for five-
minutes.
Next, a behavioral choice paradigm approach was used to assess preference for walking
under each of the television conditions. This model allows researchers to test theory driven
hypotheses regarding behavioral choices and decision-making, specifically the relative
reinforcing value of an activity, while minimizing social bias. In order to minimize potential
social bias, participants were under the assumption that they had to perform a final task, either
walking one mile or sorting paperclips. These questionnaires (10 items or each condition)
prompted participants to select whether they preferred to walk one mile under one of the
television conditions (FavTV, NatTV, or NoTV) or sort paperclips for various time periods (2, 4,
6, 8, 10, 12, 14, 16, 18, and 20 minutes). To continue to promote the deception that participants
had to complete one of these tasks after filling out the questionnaires, each one of their answers
to the 30 items was paired with a corresponding bingo ball. Participants were led to believe that
these bingo balls would be placed in a container after the questionnaires and one bingo ball
would be randomly selected to determine their final activity. Thus, individuals who circled
“walking” more often in the questionnaires had a better chance of having to complete the one-
40
mile walk under the various television conditions, while those who chose “sorting paperclips”
more often had a better chance of remaining seated and sorting paperclips. To ensure
understanding, participants were given a mock version of these procedures prior to the
presentation of the 30 items. Following completion of the three questionnaires and debriefing
procedures, participants were thanked for their time and did not have to complete the additional
task. Preference scores for each condition were calculated by taking the highest number of
minutes that an individual chose to sort paperclips (rather than walk one mile under the given
television condition) and dividing that value by two, creating a 0-10 scale. Lower scores
represented greater preference for walking under a given condition (FavTV, NatTV, and NoTV).
Scores between the questionnaires were compared to determine if the FavTV condition made
exercise more preferable than the NatTV or NoTV conditions.
Observable Behavior (Visits 3 and 4)
For both visits, participants were fitted with a HR monitor and the Feeling Scale was
administered (to account for potential differences in pre-exercise affective states). Participants
were then asked to stay in the laboratory for 60 minutes, which started once exercise was
initiated. Exercise was performed at the same work rate as visit 2 (70% of VO2-at-VT).
Participants first completed 10 minutes of walking and were notified when the required time had
elapsed. After the first 10-minutes, participants notified the research assistant when and if they
wanted to switch activities (walking or sitting). During the FavTV condition, their favorite
television program was available to watch during the entire 60 minutes, regardless of walking or
sitting behavior. During the NoTV condition, the television was turned off and covered during
exercise and only turned on to watch their favorite television program when the participant was
41
seated. Total time spent on the treadmill (treadmill walking time) was assessed as the primary
outcome of these visits.
Instruments
The Preference Tolerance for Intensity of Exercise Questionnaire (PRETIE-Q)47. The PRETIE-Q
assesses individual differences regarding the intensity of exercise preferred and the intensity that
can be tolerated. A total of 16 items, eight items relating to preference and eight items relating to
tolerance, are scored on a five point Likert Scale (1=totally disagree, 3= neutral, 5= totally
agree). Higher scores indicate greater preference/tolerance for high intensity exercise. This
questionnaire has shown to be internally consistent, structurally valid, and reliable 47, 110.
Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2)146. The BREQ-2 assesses self-
determined motivation towards PA through 19 items on a five-point Likert scale (0=not true for
me, 2=sometimes true for me, 4=very true for me). These items cluster to form five motivation
subscales (amotivation, external, introjected, identified and intrinsic motivation). Of these
factors, intrinsic motivation was the primary variable of interest due to its strong relationship
with enjoyment and preference of activities15, 88 as well as the behavioral decision making
process88. This questionnaire has been shown to be valid and reliable in a number of
populations149, 150.
Physical Activity Enjoyment Scale (PACES)85. The PACES scale consists of 18-items that are
rated on a seven-point Likert scale with opposite descriptions at each end of the scale (1=I
enjoyed it, or 7=I hated it). Participants were asked to rate their enjoyment of the preceding
42
walking bout under various television conditions, immediately following the exercise on Visit 2.
The PACES has previously been validate in children151 and adults85, 152. 153.
Rating of Perceived Exertion (RPE)147. The Borg 6-20 RPE scale was used to determine
participant’s subjective rating of exertion at the end of each stage of the VO2peak exercise test
during Visit 1 and pre, every 0.10-mile during exercise and post exercise during Visit 2. This
scale has been validated in healthy and diseased populations154, 155.
Feeling Scale102. The Feeling Scale is an 11-point scale ranging from -5 (very bad) to 5 (very
good), with 0 (neutral) as the midpoint that assesses core affect (pleasure/displeasure). Core
affect was measured pre, every 0.10-mile during exercise and post exercise during Visit 2 and
prior to exercise during Visits 3 and 4. This scale has been related to future exercise behaviors51,
102, 156 and valenced responses157.
Statistical Analyses
All analyses were conducted using SPSS v.23 (Cary, NC). For all analyses, statistical
significance was set at an alpha level of 0.05. Data are presented as mean ± standard deviation
(SD) unless otherwise noted. Independent sample T-tests were performed to determine potential
gender differences for all demographic and body composition variables (Table 1).
Behavioral Choice Paradigm
A repeated measures ANOVA was conducted on preference for exercise between
television conditions (FavTV, NatTV, NoTV). A Bonferroni post-hoc analysis was used to
43
determine where differences existed. Next, three 3x5 (television condition: FavTV, NatTV,
NoTV x time: pre, 0.10 mile, 0.20 mile, 0.30 mile, post) repeated measures ANOVAs were run
as manipulation checks on mean in-task affect, RPE and HR in order to determine if other
measures, besides television condition, influenced preference of exercise. Additionally,
frequency analyses were used to examine the percent of participants who increased, decreased or
showed no change in in-task affective responses from baseline. Correlations between preference
for exercise, enjoyment of exercise, and mean in-task affective responses were also examined.
Observable Behavior
A paired samples t-test was used to compare treadmill time between visits. Correlations
were run between treadmill time and various psychological (tolerance for exercise, preference
for exercise, enjoyment of exercise, intrinsic motivation), and physiological (VO2peak, HR at VT,
VO2-at-VT, and work rate at VT) variables. Finally, variables that were significantly correlated
with exercise time during either visit (VO2-at-VT, VO2peak, preference and tolerance for exercise
intensity) were included in a three-step hierarchical linear regression to examine the ability of
these correlated factors to predict walking time during the NoTV exercise condition. In step one,
VO2-at-VT was entered as the predictor variable. In step two, VO2peak was entered into the model
while step three included preference and tolerance for exercise.
Results
Behavioral Choice Paradigm
In regards to preference for exercise, there was a significant main effect for condition
F(2,23)=12.134, p<0.001. Specifically, preferences for FavTV (p<0.001) and NatTV (p=0.002)
were significantly higher than NoTV. There was no significant difference in preference scores
44
between FavTV and NatTV conditions (p=0.132) (Table 2).
Table 3 shows the mean ± SD for affective responses, RPE, and HR at each time point
for each television condition. The 3x5 (television condition x time) repeated measures ANOVA
for affective responses showed a significant main effect for television condition F(2,23)=6.511,
p=0.006 and time F(4,21)=4.174 (p=0.012). FavTV (p=0.004) and NatTV (p=0.007) conditions
resulted in significantly higher mean in-task affect, compared to the NoTV condition. No
differences were observed between the FavTV and NatTV conditions (p=0.554). Throughout the
FavTV, NatTV and NoTV conditions, 27%, 4%, 12%, respectively of participants increased in
affective responses while 8%, 22%, and 27%, respectively reported decreases, and 65%, 73%,
and 62% reported no change, respectively.
The 3x5 (television condition x time) repeated measures ANOVA for RPE showed a
significant main effect for condition F(2, 23) = 3.917, p=0.034 and time F(4, 21)=8.883
(p<0.001). There were significantly lower mean in-task RPE scores during the FavTV compared
to the NoTV condition (p=0.026) with no significant differences between FavTV and NatTV
conditions (p=1.000) or between NatTV and NoTV conditions (p=0.463). The 3x5 (television
condition x time) repeated measures ANOVA for mean in-task HR showed no significant main
effect for condition F(2,23)=0.821, p=0.453. However, there was a significant main effect for
time F(4,21) = 28.933 (p<0.001).
Preference for exercise with FavTV was significantly correlated with enjoyment of
exercise (r=-0.467, p=0.019) and mean in-task affective responses during the FavTV condition
(r=-0.534, p=0.006). Preference for exercise with NatTV condition was significantly correlated
with enjoyment of exercise (r=-0.500, p=0.011) and mean in-task affective responses during the
NatTV condition (r=-0.463, p=0.02). Preference for exercise with NoTV was not significantly
45
correlated with either enjoyment of NoTV (r=-0.269, p=0.193) or mean in-task affective
responses during the NoTV condition (r=-0.364, p=0.075).
Observable Behavior
There was no significant difference in treadmill time between FavTV (50.0 minutes) and
NoTV visits (44.7 minutes) (p = 0.102) (Figure 2). Walking duration during the FavTV visit was
not significantly correlated with any of the physiological or psychological variables tested
(p>0.05). Walking duration during the NoTV visit was significantly correlated with preference
(r=0.424, n=25, p=0.003) and tolerance (r=0.456, p=0.022) for high intensity exercise as
determined by the PRETIE-Q, relative VO2peak (r=0.463, p=0.020), estimated VO2max (r=0.649,
p=0.000) and relative VO2-at-VT (r=0.859, n=25, p=0.000). Model one of the regression
analysis showed that VO2-at-VT explained a significant portion of walking time during the
NoTV visit (Beta=0.485, p=0.014) (Table 4). However, VO2-at-VT, VO2peak, preference for
exercise intensity and tolerance for exercise intensity become non-significant in models two and
three.
Discussion
Results from Part A of the current study indicate that our primary hypothesis was
partially supported, in that participants more strongly preferred exercise with television over
exercise with NoTV; however, no difference in preference was noted when comparing the
FavTV versus NatTV conditions. Similar to preference for exercise, hedonic responses were
significantly higher during the FavTV and NatTV bouts compared to the NoTV exercise bout.
Results from Part B indicate that television viewing during exercise resulted in approximately
46
five minutes of additional walking behavior, which was not statistically significant. This
contradicts the initial hypothesis regarding treadmill endurance time.
Although exercise preference scores were significantly lower for walking with NoTV
compared to the other two conditions, preference for exercise did not significantly differ between
television conditions. The lack of difference between television conditions may be explained by
the exercise enjoyment results. Similar to the study of Rider et al.87, enjoyment scores for both
television conditions were significantly higher relative to the control condition (NoTV), but no
significant differences were observed between FavTV and NatTV conditions. Correlational
analyses indicated that higher enjoyment was related to stronger preference, for both conditions.
Thus, it is reasonable to speculate that many of the participants found the NatTV condition just
as appealing as their FavTV program. While contrary to the hypothesis, this finding has practical
importance because a variety of programs (regardless of whether they are chosen by individuals)
can act as a reinforcing stimulus for exercise. However, it is probably still important to avoid
explicitly aversive programming. In a study by Privitera et al.82, individuals reported increases in
post-exercise positive mood rating following 10-minutes of treadmill walking while watching an
enjoyable television program. However, those participants who reported not liking the television
program at baseline saw a non-statistically significant decrease in post-exercise mood ratings.
Although not statistically significant, the lack of change in post-exercise mood ratings among
this group demonstrates the importance of selecting neutral or preferred shows when trying to
promote positive psychological changes during exercise.
Given that core affective responses drive valenced responses (e.g. enjoyment) and
influence wanting to engage in a particular behavior, it is important to assess this variable in
terms of both mean and inter-individual responses. Mean affective responses during both
47
television-viewing conditions were approximately one unit higher than those seen during the
NoTV condition. Previous studies have reported that a one-unit increase in core affect to be
associated with increased participation in PA ranging from 15-41 minutes depending on follow-
up time period51-53, 55. However, it is important to note that, given the high inter-individual
variability in affective responses, mean values may not be wholly representative of individual
responses during exercise48. Specifically, 27% of participants in the current study reported
increased Feeling Scale scores from baseline during the FavTV condition. This increase was
more than twice the percentage of participants who reported increases during the NatTV (4%
increased) or the NoTV (12% increased) exercise bouts. Only a small percentage of participants
(8%) reported decreases in affective responses during the FavTV condition. This value is
substantially smaller compared to the percentage of participants reporting decreases in affective
responses across previous studies (21-57%)48, 51, 52, 148, 158. While these results suggest that
combining FavTV and exercise may prompt more positive individual psychological responses
despite the lack of statistical differences in mean in-task affective responses between FavTV and
NatTV conditions, these observed changes occurred over a brief 1/3-mile walk (~seven minutes
per participant). Given that these results support previous literature regarding the beneficial
effects of television viewing during exercise on hedonic responses, more research is warranted to
determine if this effect can be replicated during longer bouts of exercise.
The second objective of the current study was to determine the impact of television
viewing during exercise on treadmill walking time. Exercise duration was selected as the primary
variable as it was surmised that the availability of television might have a greater impact on how
long an individual continues to engage in aerobic exercise versus how hard an individual is
willing to work. While results from Part A suggests that television viewing enhances the
48
reinforcing value of exercise (via hedonic responses and preferences), results from Part B
indicate that the difference in walking time between the two conditions (~5 minutes) was not
statistically significant.
Another interesting finding was that the physiological and psychological variables that
are significantly correlated with exercise time during the NoTV condition did not significantly
predict behavior when entered into a hierarchical linear regression. Although one might expect
each of these variables to independently influence exercise behaviors, given that individuals with
higher fitness levels, higher preference or higher tolerance for exercise may participate in greater
amounts of PA, these results demonstrate the complex relationships between a single outcome
measure and behavior. Thus, it is important to examine the interplay between these physiological
and psychological variables and observable behavior. Future studies should examine multiple
behavioral occasions (e.g. how many times does an individual work out each week) and utilize
more sensitive analyses such as a principal components analysis to obtain a deeper understanding
of how such constructs influence exercise-related behavioral choices.
Regarding the walking behaviors observed in the current study, several anecdotal
observations are worth mentioning in terms of optimizing future laboratory experiments. First,
several participants indicated that they used Visits 3 and 4 as a free time to exercise (i.e. “I’m
here for 60 minutes, I might as well walk”). In this regard, 36% of participants walked the full 60
minutes for both FavTV and NoTV conditions. It was hypothesized that an insufficiently active
individual would not walk for an hour, however this ceiling effect raises concerns. Future studies
may consider extending this time limit. Additionally, despite the autonomy of allowing
individuals to choose their favorite television program, this approach may be problematic.
Overall, 60% of participants chose television programs that included instances of violence,
49
death, rape, or sexual innuendo. More striking is that 50% of male participants apologized to the
research assistant for their program’s content, suggesting some level of discomfort during the
visit. This poses a conundrum, in that a research assistant should be present for safety reasons,
but it could also place an emotional burden on the participants based on their television program
choice. Given that no differences in psychological variables were noted between television
conditions in Part A (FavTV vs. NatTV), future research may benefit from choosing a non-
aversive show to reduce the discomfort some participants may feel by watching their preferred,
but potentially suggestive television program with a stranger. As noted by Privitera et al.82,
aversive television program themes can impact mood responses. While the individuals were not
opposed to the content (given their choice in viewing), the addition of a relative stranger (the
researcher) could undermine any positive impact of letting people choose their own show. It is
possible that participants chose to exercise longer during the NoTV visit than they would in a
more natural setting (e.g. their home) in order to avoid watching certain programs in the altered
social environment imposed by the laboratory setting. Taken together, future research should
consider this aspect during study design to determine the necessity of allowing choice in
television programming.
This study is not without limitations. Although all individuals self-reported a favorite, or
preferred television program, typical television viewing behaviors were not assessed. Typical
television viewing behaviors may have contributed to how long participants were willing to walk
during Part B. For example, individuals who watch less television may not have been as inclined
to stop or take breaks from exercise, particularly during the NoTV condition. Additionally, only
one mode of exercise was assessed during this study. Walking was selected, as it is the most
commonly reported leisure time PA among U.S. adults159-161. However, it is possible that other
50
modes of exercise may alter psychological constructs differently. Specifically, if individuals
experience musculoskeletal discomfort while walking, a cycle ergometer may be a more
comfortable and enjoyable mode of exercise. Other limitations to this study include that only one
behavioral outcome (walking duration), and one exercise work rate (70% VO2-at-VT) were
investigated. It is possible that the differences in walking time while watching a preferred
television program may be augmented when individuals exercise at intensities above VT. In
addition, higher exercise intensities may have limited the number of individuals who exercised
for the entire 60-minutes during both visits, reducing the ceiling effect observed in the current
study.
Conclusions
Results from the current study provide further insight into exercise related behavioral
choices. This study demonstrated that individuals prefer walking with television viewing over
walking with no television. Results from the current study also support previous findings
regarding the beneficial effects of television viewing during exercise on affective responses and
enjoyment of exercise. While the five additional minutes spent on the treadmill with television
viewing did not reach statistical significance, these results suggests that further research should
be conducted to understand the behavioral impact of television viewing during exercise.
51
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APPENDICES
62
APPENDIX A
Tables and Figures
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Table 1. Participant characteristics (mean±SD).
*Denotes significantly different from male participants (p<0.05). y: years, cm: centimeters, kg:
kilograms, BMI: body mass index, %: percent, Avg: average, PA: physical activity, mins:
minutes, VO2peak: peak oxygen consumption, ml: milliliters, HR: heart rate, bpm: beats per
minute, VO2: oxygen consumption VT: ventilatory threshold.
Total (n=25)
Males (n=8) Females (n=17)
Age (y) 46±12 46±15 46±11 Height (cm) 169.1±8.2 176.8±9.1 165.4±4.6* Weight (kg) 90.5±17.6 98.0±16.7 86.9±17.8. BMI (kg/m2) 31.2±5.3 30.2±2.9 31.6±6.2 Body Fat (%) 36.1±7.3 29.4±4.8 39.4±5.8*
Avg. PA/Week (mins/week) 63±58 67±60 65±59 VO2peak (ml·kg-1·min-1) 21.9±4.8 24.8±4.5 20.5±4.4
HR at VT (bpm) 128±19 118±20 133±17 VO2-at-VT (ml·kg-1·min-1) 15.2±3.1 15.6±2.8 14.9±3.2
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Table 2. Relative preference (mean±SD) for exercise scores under three television-viewing
conditions.
FavTV NatTV NoTV
Total (n=25) 1.1±1.3 1.8±1.9 3.0±2.7* *Denotes significantly different from FavTV and NatTV conditions (p<0.05). Lower scores
indicate greater preference for exercise during specified television condition. FavTV;
participant’s self-reported favorite television program, NatTV: Episode 1 (Challenges of Life) of
the British Broadcasting Company’s Life program, NoTV: no television program.
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Table 3. Feeling scale (FS), heart rate (HR) and rating of perceived exertion (RPE) responses
(mean±SD) prior to, during and following exercise under various television conditions.
Variable Condition Pre-Exercise
0.10 mile
0.20 mile
0.30 mile
Post-Exercise
FS FavTV 2.7±1.9 3.3±1.5 3.5±1.4 3.5±1.4 3.2±1.7
NatTV 2.7±2.0 3.4±1.6 3.2±1.6 3.1±1.7 3.2±1.7
NoTV 2.6±2.1 2.5±1.7 2.4±1.8 2.4±1.7 2.4±1.8
HR (bpm) FavTV 94±17 108±15 108±15 110±15 109±15
NatTV 95±18 107±15 110±17 110±16 109±16
NoTV 94±18 109±15 110±15 110±16 110±16
RPE FavTV 6.3±0.7 7.6±1.7 8.0±2.0 8.4±2.0 7.1±1.8
NatTV 6.3±0.7 7.6±1.8 8.1±2.0 8.6±2.3 7.3±2.3
NoTV 6.2±0.7 7.7±1.9 8.6±2.3 9.1±2.5 7.4±2.0
FavTV; participant’s self-reported favorite television program, NatTV: Episode 1 (Challenges of
Life) of the British Broadcasting Company’s Life program, NoTV: no television program.
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Table 4. Results From Regression Analysis.
*Denotes statistical significance (p<0.05), VO2: oxygen consumption (ml·kg·-1·min-1),
VT: ventilatory threshold, VO2peak: peak oxygen consumption (ml·kg·-1·min-1),
Preference: preference for exercise intensity as determined by the Preference and
Tolerance for Intensity of Exercise Questionnaire, Tolerance: tolerance for exercise
intensity as determined by the Preference and Tolerance for Intensity of Exercise
Questionnaire.
β Standard
Error Beta T P value
Model 1 VO2-at-VT 2.487 0.935 0.485 2.66 0.014* Model 2 VO2-at-VT 1.703 1.857 0.332 0.917 0.369 VO2Peak 0.580 1.179 0.178 0.492 0.628 Model 3 VO2-at-VT 1.979 1.814 0.386 1.091 0.601
VO2Peak -0.106 1.224 -0.033 -0.087 0.932 Preference 0.243 0.721 0.082 0.337 0.740 Tolerance 0.947 0.649 0.317 1.460 0.160
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Figure 1. Experimental design of Visit 2 which included three randomized 1/3-mile walking
bouts performed at 70% oxygen consumption at ventilatory threshold while either watching their
self-reported favorite television program (FavTV) a nature program (NatTV) or no television
(NoTV). In between walking bouts, participants completed the Physical Activity Enjoyment
Scale (PACES) and a 5-minute sedentary activity (paperclip sorting).
68
Figure 2. Average walking duration (standard deviation bars) while watching self-reported
favorite television program (FavTV) or no television programming (NoTV) during a 60-minute
laboratory visit. No statistically significant differences between conditions were observed.
10
20
30
40
50
60
70
FavTV NoTV
Trea
dmill
End
uran
ce T
ime
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utes
)
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APPENDIX B
Informed Consent
70
71
72
73
APPENDIX C
Recruitment Flyer
74
Research Recruitment Flyer
What Will It Take To Get YOU To
Exercise? The Applied Physiology Laboratory at The University of Tennessee is
conducting a study to help determine the effects of television viewing during exercise.
Qualifications • Between the 30 and 65 years of age
• Able to walk 1-mile • Not currently exercising on 3 or more days each week
If you meet the additional study criteria, you will be eligible to participate in
an exercise study that will measure your heart rate, fitness and feelings towards exercise.
Receive A Free Health Summary!
4 visits to the Applied Physiology Lab Approximate time commitment <1.5 hours per session
Please contact Brittany Overstreet at [email protected] for more details.
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RESEARCH STUDY
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APPENDIX D
Participant Recruitment Email
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Research Recruitment Email
Good (morning/afternoon),
The Applied Physiology Laboratory is currently looking for volunteers to participate in
an upcoming research study examining the psychological, physical and behavioral effects of
television viewing during exercise. Volunteers should be between 25-70 years old, exercising
less than <3 days per week, and have no known health conditions that would prevent
participation in exercise. This study requires 4 visits, each 1-1.5 hours long, to the Health,
Physical Education and Recreation building (room 317). For your participation in the study, you
will receive a health assessment summary including information regarding your body
composition and cardiorespiratory fitness levels. If interested, or to obtain more information,
please contact Brittany Overstreet at [email protected].
Thank you,
Brittany Overstreet Doctoral Candidate Department of Kinesiology, Recreation and Sport Studies 1914 Andy Holt Ave Knoxville, TN 37996 Phone: 865-974-6040 Fax: 865-974-8981 Email: [email protected]
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APPENDIX E
Participant Results Sheet
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Results Summary Sheet For Participant (Example)
(Participant’s name) –
Thank you for your participation in the Effects of Television Viewing On Psycho-
Physiological And Behavioral Outcomes research study. Here are your results from your body
composition and fitness testing. Your values are presented below along with normal ranges for
each measurement as stated by the American College of Sports Medicine. Bolded values indicate
values outside of the desired range for optimal health. If you have any questions regarding these
values we suggest you contact your primary care physician. If you have any questions about your
involvement, results or general questions regarding the study please feel free to contact me.
It has been a pleasure working with you,
Brittany Overstreet Doctoral Candidate Dept. of Kinesiology, Recreation, and Sport Studies 1914 Andy Holt Ave Knoxville, TN 37996 Phone: 865-974-6040
Variable Your Value
Normal or ideal-range for optimal health
Weight (lbs)
Height (cm) n/a
Percent body fat (%) BMI (kg/m2)
VO2max (ml·kg·min-1)
Fitness percentile (%)
Maximal heart rate (bpm)
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APPENDIX F
Behavioral Risk Factor Surveillance Survey
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Exercise History Questionnaire
2009 BRFSS Physical Activity Questionnaire
Instructor Note: If the individual is “Employed for wages” or “Self-employed answer 19.1, if not – skip and
go to 19.2. If respondent has multiple jobs, include all jobs.
19.1: Instructor reads: When you are at work, which of the following best describes what you do? Would
you say –
1. Mostly sitting or standing
2. Mostly walking
3. Mostly heavy labor or physically demanding work
Instructor does not read:
4. Doesn’t know/Not sure
5. Refused
Instructor reads: We are interested in two types of physical activity – vigorous and moderate. Vigorous
activities cause large increases in breathing or heart rate while moderate activities cause small increases in
breathing or heart rate.
19. 2 Instructor reads: Now, thinking about the moderate activities you do (fill in “when you are not
working” if employed or self-employed) in a usual week, do you do moderate activities for at least 10-
minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes
some increase in breathing or heart rate?
1. Yes
2. No (Go to 19.5)
3. Doesn’t know/Not sure (Go to 19.5)
4. Refused (Go to 19.5)
19. 3 Instructor reads: How many days per week do you do these moderate activities for at least 10-minutes
at a time?
1. ____ Days per week
2. Do no do any moderate physical activity for at least 10-minutes at a time (Go to 19.5)
3. Doesn’t know/Not sure (Go to 19.5)
4. Refused (Go to 19.5)
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APPENDIX G
Health History Questionnaire
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Health History Questionnaire
Name: Address: City: Zip Code: Phone: Date of Birth: Age: Gender: ___ M F UT Faculty/Staff: Y N Occupation: Full Time? Y N Marital Status: (circle one) Single Married Divorced Widowed Education: (check highest level completed) Elementary High School College Graduate School Race: White American Indian Asian Hispanic Black / African American Native Hawaiian / Pacific Islander Other Personal Physician: Location:
Are you taking any prescription or over-the counter medication? YES NO Name of Medication Reason for Taking For How Long?
Please Turn Over
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Emergency Contact Name:
Relationship: Phone: Work:
Home:
PAST HISTORY Have you ever had? (please check all that apply)
_____ Heart attack
_____ Any heart problems
_____ Arthritis
_____ Recurring leg pain (not related to arthritis)
_____ Liver or Kidney Disease
_____ Any breathing or lung problems
_____ Ankle swelling (not related to twisting)
_____ Low back or joint problems
Uncontrolled Diabetes
Cancer
_____ Blood Clots
_____ Stroke
PRESENT SYMPTOMS Do you currently have? (Please check all that apply) _____ Chest pain / discomfort _____ Cough on exertion _____ Shortness of breath _____ Coughing of blood _____ Heart palpitations _____ Dizzy spells _____ Skipped heart beats _____ Frequent headaches _____ Chronic Fatigue Syndrome _____ Orthopedic / joint problems
_____ Diabetes _____ Back Pain
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APPENDIX H
Preference and Tolerance for Intensity of Exercise Questionnaire
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Preference and Tolerance for Intensity of Exercise Questionnaire (PRETIE-Q)
Participant ID________ Session__________ Date__________ Instructions for survey: Please read each of the following statements and then use the response
scale below to indicate whether you agree or disagree with it. There are no right or wrong answers. Work quickly and mark the answer that best describes what you believe and how you feel. Make
sure that you respond to all the questions. Totally
Disagree Disagree Neutral Agree Totally
Agree 1. Feeling tired during exercise is my signal to slow down or stop
1 2 3 4 5
2. I would rather work out at low intensity levels for a long duration than at high-intensity levels for a short duration
1 2 3 4 5
3. During exercise, if my muscles begin to burn excessively or if I find myself breathing very hard, it is time for me to ease off
1 2 3 4 5
4. I’d rather go slow during my workout, even if that means taking more time
1 2 3 4 5
5. While exercising, I try to keep going even after I feel exhausted.
1 2 3 4 5
6. I would rather have a short, intense work out than a long, low –intensity workout
1 2 3 4 5
7. I block out the feeling of fatigue when exercising
1 2 3 4 5
8. When I exercise, I usually prefer a slow steady pace
1 2 3 4 5
9. I’d rather slow down or stop when a workout starts to get too tough
1 2 3 4 5
10. Exercising at low intensity does not appeal to me at all
1 2 3 4 5
11. Fatigue is the last thing that affects when I a workout; I have a goal and stop only when I reach it
1 2 3 4 5
12. While exercising, I prefer activities that are slow-paced and do not require much exertion
1 2 3 4 5
13. When my muscles start burning during exercise, I usually ease off some
1 2 3 4 5
14. The faster and harder the workout, the more pleasant I feel
1 2 3 4 5
15. I always push through muscle soreness and fatigue when working out
1 2 3 4 5
16. Low-intensity exercise is boring 1 2 3 4 5
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APPENDIX I
Behavioral Regulation In Exercise Questionnaire
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Behavioral Regulation in Exercise Questionnaire (BREQ-2) Participant ID________ Session__________ Date__________
WHY DO YOU ENGAGE IN EXERCISE? We are interested in the reasons underlying peoples’ decisions to engage, or not engage in physical exercise. Using the scale below, please indicate to what extent each of the following items is true for you. Please note that there are no right or wrong answers and no trick questions. We simply want to know how you personally feel about each question. Your responses will be held in confidence and only used for our research purposes.
1. I exercise because other people say I should 0 1 2 3 4
2. I feel guilty when I don’t exercise 0 1 2 3 4 3. I value the benefits of exercise 0 1 2 3 4
4. I exercise because it’s fun 0 1 2 3 4
5. I don’t see why I should have to exercise 0 1 2 3 4 6. I take part in exercise because my friends/family/partner say I should 0 1 2 3 4
7. I feel ashamed when I miss an exercise session 0 1 2 3 4
8. It’s important for me to exercise regularly 0 1 2 3 4 9. I can’t see why I should bother exercising 0 1 2 3 4 10. I enjoy my exercise sessions 0 1 2 3 4
11. I exercise because others will not be pleased with me if I don’t 0 1 2 3 4
12. I don’t see the point in exercising 0 1 2 3 4 13. I feel like a failure when I haven’t exercised in a while 0 1 2 3 4
14. I think it is important to make the effort to exercise regularly 0 1 2 3 4
15. I find exercise a pleasurable activity 0 1 2 3 4 16. I feel under pressure from my friends/family to exercise 0 1 2 3 4
17. I get restless if I don’t exercise 0 1 2 3 4
18. I get pleasure and satisfaction from participating in exercise 0 1 2 3 4
19. I think exercise is a waste of time 0 1 2 3 4
Not true for me
Sometimes true for me
Very true for me
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APPENDIX J
Rating of Perceived Exertion
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Borg’s Rating Of Perceived Exertion (RPE) Scale 6 NO EXERTION AT ALL 7 EXTREMELY LIGHT 8 9 VERY LIGHT 10 11 LIGHT 12 13 SOMEWHAT HARD 14 15 HARD (HEAVY) 16 17 VERY HARD 18 19 EXTREMELY HARD 20 MAXIMAL EXERTION Verbal instructions for scale to be read by instructor : While doing physical activity, we want you to rate your perception of exertion. This feeling should reflect how heavy and strenuous the exercise feels to you, combining all sensations and feelings of physical stress, effort, and fatigue. Do not concern yourself with any one factor such as leg pain or shortness of breath, but try to focus on your total feeling of exertion.
Look at the rating scale below while you are engaging in an activity; it ranges from 6 to 20, where 6 means "no exertion at all" and 20 means "maximal exertion." Choose the number from below that best describes your level of exertion.
Try to appraise your feeling of exertion as honestly as possible, without thinking about what the actual physical load is. Your own feeling of effort and exertion is important. Look at the scales and the expressions and then give a number.
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APPENDIX K
Feeling Scale
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FEELING SCALE
+5 Very Good
+4
+3 Good
+2
+1 Fairly Good
0 Neutral
-1 Fairly Bad
-2
-3 Bad
-4
-5 Very Bad
Verbal instructions for scale to be read by instructor:
While participating in exercise, it is common to experience changes in mood. Some individuals
find exercise pleasurable, whereas others find it to be unpleasant. Additionally, feeling may
fluctuate across time. That is, one might feel good and bad a number of times during exercise.
Scientists develop this scale to measure such responses. Please indicate your level of pleasure or
displeasure you are experiencing right now.
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APPENDIX L
Physical Activity Enjoyment Scale
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Physical Activity Enjoyment Scale (PACES)
Participant ID________ Session__________ Date__________
Physical Activity Enjoyment Scale Please review each scenario below and rank each one from 1 to 7 based on which side of the
scale you feel best represent how you feel about the exercise bout you just performed.
I enjoyed it I hated it 1 2 3 4 5 6 7
I felt bored I felt interested
1 2 3 4 5 6 7 I disliked it I liked it
1 2 3 4 5 6 7
I found it pleasurable I found it un-pleasurable
1 2 3 4 5 6 7
I was very absorbed with the exercise I was not at all absorbed with the exercise
1 2 3 4 5 6 7 It was no fun at all It was a lot of fun
1 2 3 4 5 6 7
I found it energizing I found it tiring
1 2 3 4 5 6 7
It made me depressed It made me happy
1 2 3 4 5 6 7 It was very pleasant It was very unpleasant
1 2 3 4 5 6 7
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I felt good physically I felt bad physically while doing it while doing it
1 2 3 4 5 6 7 It was very invigorating It was not at all invigorating
1 2 3 4 5 6 7 I was very frustrated by it I was not at all frustrated by it
1 2 3 4 5 6 7 It was very gratifying It was not at all gratifying
1 2 3 4 5 6 7 It was very exhilarating It was not at all exhilarating
1 2 3 4 5 6 7 It was not at all stimulating It was very stimulating
1 2 3 4 5 6 7 It gave me a strong It did not give me a strong sense of accomplishment sense of accomplishment
1 2 3 4 5 6 7 It was very refreshing It was not at all refreshing
1 2 3 4 5 6 7
I felt as though I there was nothing I felt as though there was something else I would rather be doing else be I would rather be doing
1 2 3 4 5 6 7
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APPENDIX M
Behavioral Choice Paradigm Practice Questionnaire
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Practice Behavioral Choice Paradigm Questionnaire
Please answer the following practice questions by circling the option you would prefer completing.
1. Walking 1-mile outside or sitting and sorting paperclips for 2-minutes
2. Walking 1-mile outside or sitting and sorting paperclips for 4-minutes
3. Walking 1-mile outside or sitting and sorting paperclips for 6-minutes
4. Walking 1-mile outside or sitting and sorting paperclips for 8-minutes
5. Walking 1-mile outside or sitting and sorting paper-clips for 10-minutes
6. Walking 1-mile outside or sitting and sorting paperclips for 12-minutes
7. Walking 1-mile outside or sitting and sorting paperclips for 14-minutes
8. Walking 1-mile outside or sitting and sorting paperclips for 16-minutes
9. Walking 1-mile outside or sitting and sorting paperclips for 18-minutes
10. Walking 1-mile outside or sitting and sorting paperclips for 20-minutes
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APPENDIX N
Behavioral Choice Paradigm Questionnaires
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Behavioral Choice Paradigm Questionnaire Part A: Self-Selected Television Program Reflect on the 1/3 of a mile walking bout you previously completed while watching your favorite television program and the 5-minute paperclip-sorting task that followed. Please answer the following questions by circling which option (treadmill walking or paper-clip sorting) you would prefer completing for each scenario. For each option that you choose walking 1-mile over paper clip sorting, the associated bingo ball will be placed in a container. Once you complete all 30-questions, one bingo ball will be randomly selected and you will perform the activity associated with that bingo ball. 1. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips
for 2-minutes Bingo balls = White A1
2. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips
for 4-minutes Bingo balls = White A2
3. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips
for 6-minutes Bingo balls = White A3
4 Walking 1-mile while watching your self-selected TV show or sitting and sorting paper-clips
for 8-minutes Bingo balls = White A4
5. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips
for 10-minutes Bingo balls = White A5
6. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips
for 12-minutes Bingo balls = White A6
7. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips
for 14-minutes Bingo balls = White A7
8. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips
for 16-minutes Bingo balls = White A8
9. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips
for 18-minutes Bingo balls = White A9
10. Walking 1-mile while watching your self-selected TV show or sitting and sorting paperclips for 20-minutes Bingo balls = White A10
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Behavioral Choice Paradigm Questionnaire Part B: Nature Television Program Reflect on the 1/3 of a mile walking bout previously completed while watching the nature (Life) television program and the 5-minute paperclip-sorting task that followed. Please answer the following questions by circling which option (treadmill walking or paper-clip sorting) you would prefer completing for each scenario. For each option that you choose walking 1-mile over paper clip sorting, the associated bingo ball will be placed in a container. Once you complete all 30-questions, one bingo ball will be randomly selected and you will perform the activity associated with that bingo ball. 11. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 2-minutes Bingo balls = Blue B1
12. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 4-minutes Bingo balls = Blue B2
13. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 6-minutes Bingo balls = Blue B3
14 Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 8-minutes Bingo balls = Blue B4
15. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 10-minutes Bingo balls = Blue B5
16. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 12-minutes Bingo balls = Blue B6
17. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 14-minutes Bingo balls = Blue B7
18. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 16-minutes Bingo balls = Blue B8
19. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips
for 18-minutes Bingo balls = Blue B9
20. Walking 1-mile while watching the Nature TV show or sitting and sorting paperclips for 20-minutes Bingo balls = Blue B1
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Behavioral Choice Paradigm Questionnaire Part C: No Television Program Reflect on the 1/3 of a mile walking bout you previously completed without any television program viewing and the 5-minute paperclip-sorting task that followed. Please answer the following questions by circling which option (treadmill walking or paperclip-sorting) you would prefer completing for each scenario. For each option that you choose walking 1-mile over paper clip sorting, the associated bingo ball will be placed in a container. Once you complete all 30-questions, one bingo ball will be randomly selected and you will perform the activity associated with that bingo ball. 21. Walking 1-mile without TV viewing or sitting and sorting paperclips for 2-minutes
Bingo balls = Red C1
22. Walking 1-mile without TV viewing or sitting and sorting paperclips for 4-minutes
Bingo balls = Red C2
23. Walking 1-mile without TV viewing or sitting and sorting paperclips for 6-minutes
Bingo balls = Red C3
24. Walking 1-mile without TV viewing or sitting and sorting paperclips for 8-minutes
Bingo balls = Red C4
25. Walking 1-mile without TV viewing or sitting and sorting paperclips for 10-minutes
Bingo balls = Red C5
26. Walking 1-mile without TV viewing or sitting and sorting paperclips for 12-minutes
Bingo balls = Red C6
27. Walking 1-mile without TV viewing or sitting and sorting paperclips for 14-minutes
Bingo balls = Red C7
28. Walking 1-mile without TV viewing or sitting and sorting paper-clips for 16-minutes
Bingo balls = Red C8
29. Walking 1-mile without TV viewing or sitting and sorting paperclips for 18-minutes
Bingo balls = Red C9
30. Walking 1-mile without TV viewing or sitting and sorting paperclips for 20-minutes Bingo ball = Red C1
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APPENDIX O
Participant Debrief Script
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Debriefing Script
To be read by investigator: Thank you for completing the behavioral-choice questionnaire and for your participation in our study thus far. Although you were originally told you would now be completing randomly selected final task, we will not be requiring you to perform that task. The purpose of informing you that you would perform a final task was to promote truthful and honest answers and to prevent passive answering of the questionnaire. Did you have any inclination that you would not be asked to complete this task? (YES or NO). If you would like to complete the 1-mile walking bout or paperclip-sorting task, I would be more than happy to carry out the remainder of the project as previously described. If not, then I am more than willing to answer any questions you may have at this point. Additionally, just for your information, this is the only time during the study that you will have to complete a bout of exercise you were told you would have to do. During the next two visits you will have to perform the exercise as we have previously discussed. If you have no further questions we can schedule your remaining visits at this time.
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VITA
Brittany Star Overstreet was born in Mount Airy, MD on January 8, 1989 where she was
raised and graduated from Linganore High School in 2007. She earned her Bachelor of Science
degree in Exercise Science with an Allied Health Track from Salisbury University in 2011 and
completed her Masters of Science degree in Clinical Exercise Physiology at Ball State University
in 2013. Following the completion of her Masters degree, she moved to Knoxville, Tennessee to
begin her doctoral work at the University of Tennessee in the Department of Kinesiology,
Recreation, and Sport Studies under the advisement of Dr. David Bassett, Jr. She completed her
Doctor of Philosophy degree in Kinesiology and Sports Studies in August 2016. After
completing her Ph.D., she assumed a faculty position in the Department of Kinesiology and
Applied Physiology at The University of Delaware.
